Provider Demographics
NPI:1326127838
Name:ROH, JONI LEE (EDD, ATC)
Entity Type:Individual
Prefix:MRS
First Name:JONI
Middle Name:LEE
Last Name:ROH
Suffix:
Gender:F
Credentials:EDD, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 WAGNER RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501-6408
Mailing Address - Country:US
Mailing Address - Phone:304-296-3758
Mailing Address - Fax:
Practice Address - Street 1:250 UNIVERSITY AVENUE
Practice Address - Street 2:CALIFORNIA UNIVERSITY OF PENNSYLVANIA
Practice Address - City:CALIFORNIA
Practice Address - State:PA
Practice Address - Zip Code:15419
Practice Address - Country:US
Practice Address - Phone:724-809-9411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART000933A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer