Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology |
NPI | 1235669896 |
---|---|
Provider Name | Megan Kwon |
First Address | Pasadena, CA 91106-5506 |
Second Address | Long Beach, CA 90806-2426 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2017 |
Last Update Date | 15/06/2017 |