Most Relevant Information
Provider Data
| NPI Number: | 1003580093 |
| Provider Name: | MEGAN ELIZABETH KOONTZ ATC, CSCS |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | 1406 |
Most Important Dates
| Enumeration Date: | 08/04/2021 |
| Last Updated: | 08/04/2021 |
Provider Practice Location
99 SQUIRES GROVE DR E
ATOKA
TN
380042705
Practice Location Phone/Fax
| Phone: | 7314420749 |
| Fax: |
Provider Mailing Location
99 SQUIRES GROVE DR E
ATOKA
TN
380042705
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |