Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | MD465845 | PA |
NPI | 1063826972 |
---|---|
Provider Name | Megan Labuz |
First Address | Allentown, PA 18104-2268 |
Second Address | Allentown, PA 18104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2014 |
Last Update Date | 14/11/2018 |