Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 5629 | OR |
NPI | 1013386275 |
---|---|
Provider Name | Megan Lucile Adams |
First Address | Milwaukie, OR 97267-4349 |
Second Address | Portsmouth, NH 03801-4086 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2015 |
Last Update Date | 17/09/2015 |