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General NPI Number Information
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NPI Number | 1093603979
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Entity Type | Individual
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Provider Name | SHAWN JUSTIN SNEAD MS, LAT, ATC
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Gender | Male
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Dates
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Enumeration Date | 06/27/2025
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 24790 MEADOWS FARMS CT
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City | SOUTH RIDING
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State | VA
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Zip | 20152-3000
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Country | US
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Telephone | 703-372-4445
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Fax |
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Provider Business Mailing Address
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Address Line | 43835 TIMBER SQ UNIT 107
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City | LEESBURG
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State | VA
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Zip | 20176-3436
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Country | US
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Telephone |
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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 | 0126003745
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License Number State | VA
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