MEDICARE: MEGAN ANNE BONE LAT, ATC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer	0126004289	VA

General Provider Information

NPI Number	:	1215870282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN ANNE BONE LAT, ATC

Provider Business Mailing Address
First Line	:	11810 FORBIDDEN FOREST CIR APT 106
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22407-3321
Country	:	US
Telephone Number	:	832-623-5358
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 COLLEGE AVE
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22401-5300
Country	:	US
Telephone Number	:	540-654-1874
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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