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General NPI Number Information
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NPI Number | 1649744319
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Entity Type | Individual
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Provider Name | MEGAN ELIZABETH MARQUART ATC
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Gender | Female
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Dates
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Enumeration Date | 01/16/2019
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Last Update Date | 07/24/2020
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Provider Practice Location Address
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Address Line | 435 N 5TH ST
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City | PHOENIX
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State | AZ
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Zip | 85004-2157
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Country | US
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Telephone | 602-827-2450
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Fax |
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Provider Business Mailing Address
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Address Line | 4151 N WESTVIEW DR
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City | PHOENIX
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State | AZ
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Zip | 85015-5242
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Country | US
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Telephone | 717-525-3389
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | ATTL-000189
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License Number State | AZ
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