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Meg Anne Fensholt, PTA

Physical Therapy Assistant in Wheaton, IL. Individual provider (NPI-1).

NPI number1306196753
StatusActive
Last updated in NPPESSep 13, 2012

Details

NPI
1306196753
Entity type
Individual (NPI-1)
Name
Meg Anne Fensholt
Credential
PTA
Sex
Female
Sole proprietor
Yes
Enumeration date
Sep 13, 2012
Last updated
Sep 13, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225200000X Physical Therapy Assistant160.005752ILYes

Practice location

220 W Jefferson Ave
Wheaton, IL 60187-4111

Phone 630-690-3315

Mailing address

220 W Jefferson Ave
Wheaton, IL 60187-4111

Phone 630-690-3315

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