Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 3479 | NH |
N | 2251G0304X | Physical Therapist - Geriatrics | 3479 | NH |
NPI | 1265776611 |
---|---|
Provider Name | Mrs. Megan Lynn St. Onge |
First Address | Henniker, NH 03242-3448 |
Second Address | Boscawen, NH 03303-2415 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2012 |
Last Update Date | 14/05/2019 |