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General NPI Number Information
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NPI Number | 1326127838
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Entity Type | Individual
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Provider Name | JONI LEE ROH EDD, ATC
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Gender | Female
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 250 UNIVERSITY AVENUE CALIFORNIA UNIVERSITY OF PENNSYLVANIA
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City | CALIFORNIA
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State | PA
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Zip | 15419
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Country | US
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Telephone | 724-809-9411
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Fax |
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Provider Business Mailing Address
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Address Line | 300 WAGNER RD
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City | MORGANTOWN
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State | WV
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Zip | 26501-6408
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Country | US
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Telephone | 304-296-3758
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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 | RT000933A
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License Number State | PA
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