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General NPI Number Information
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NPI Number | 1033593496
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Entity Type | Individual
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Provider Name | MEAGAN SEBRELL
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Gender | Female
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Dates
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Enumeration Date | 07/16/2015
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Last Update Date | 07/16/2015
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Provider Practice Location Address
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Address Line | 2550 S. SR. 100
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City | TIFFIN
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State | OH
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Zip | 44883
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Country | US
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Telephone | 419-447-7203
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Fax | 419-447-5577
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Provider Business Mailing Address
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Address Line | PO BOX 833
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City | TIFFIN
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State | OH
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Zip | 44883
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Country | US
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Telephone | 419-447-7203
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Fax | 419-447-5577
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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 | AT.004290
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License Number State | OH
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