Individual provider · NPI-1

Megan Herter

Specialist/Technologist, Athletic Trainer · Springfield, IL

NPI number1740806413
StatusActive
Last updated in NPPESJun 18, 2020

Details

NPI
1740806413
Entity type
Individual (NPI-1)
Name
Megan Herter
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 18, 2020
Certification date
Jun 18, 2020
Last updated
Jun 18, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic Trainer––Yes

Practice location

1513 Old Ivy Dr
Springfield, IL 62711-8156

Phone 217-816-7052

Mailing address

1513 Old Ivy Dr
Springfield, IL 62711-8156

Phone 217-816-7052

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