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General NPI Number Information
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NPI Number | 1538406327
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Entity Type | Individual
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Provider Name | MEGAN ROACH MA, LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 01/14/2013
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 2288 MAIN ST E
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City | SNELLVILLE
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State | GA
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Zip | 30078-3397
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Country | US
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Telephone | 770-972-4840
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Fax |
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Provider Business Mailing Address
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Address Line | 2099 HEDGEWOOD TRCE
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-2658
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Country | US
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Telephone | 910-987-0258
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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 | 0126001918
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT003829
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License Number State | GA
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