Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics |
NPI | 1083999353 |
---|---|
Provider Name | Margaret Ann Lupo |
First Address | Granite Falls, WA 98252-8632 |
Second Address | Granite Falls, WA 98252-8632 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2011 |
Last Update Date | 29/10/2018 |