Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | MI |
NPI | 1225701006 |
---|---|
Provider Name | Megan Elizabeth O'mara |
First Address | Grand Rapids, MI 49506-2921 |
Second Address | Grand Rapids, MI 49506-2921 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2021 |
Last Update Date | 28/07/2021 |