Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MT21204285 | IN |
NPI | 1003235532 |
---|---|
Provider Name | Megan Leigh Garrison |
First Address | Carmel, IN 46032-3599 |
Second Address | Carmel, IN 46032-3599 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2014 |
Last Update Date | 14/04/2014 |