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General NPI Number Information
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NPI Number | 1558380147
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Entity Type | Individual
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Provider Name | SHARON MENEGONI ATC
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Gender | Female
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 201 HIGH ST LONGWOOD UNIVERSITY
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City | FARMVILLE
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State | VA
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Zip | 23909-1800
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Country | US
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Telephone | 434-395-2845
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Fax | 434-395-2380
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Provider Business Mailing Address
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Address Line | 1506 4TH AVE EXT
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City | FARMVILLE
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State | VA
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Zip | 23901
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Country | US
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Telephone | 434-315-0006
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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 | 0126000028
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License Number State | VA
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