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General NPI Number Information
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NPI Number | 1619428612
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Entity Type | Individual
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Provider Name | MARAH JONES ATC
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Gender | Female
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Dates
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Enumeration Date | 10/14/2016
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Last Update Date | 10/14/2016
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Provider Practice Location Address
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Address Line | 1460 UNIVERSITY DR
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City | WINCHESTER
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State | VA
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Zip | 22601-5100
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Country | US
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Telephone | 540-542-6505
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Fax |
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Provider Business Mailing Address
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Address Line | 518 YORKTOWNE PL
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City | WINCHESTER
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State | VA
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Zip | 22601-3449
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Country | US
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Telephone | 540-255-2965
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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 | 0126002519
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License Number State | VA
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