Provider Demographics
NPI:1407804487
Name:ABRAMOVICH, DARLENE A (ATC)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:A
Last Name:ABRAMOVICH
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 HIGH STREET-ATHLETICS
Mailing Address - Street 2:LONGWOOD UNIVERSITY
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901
Mailing Address - Country:US
Mailing Address - Phone:434-395-2017
Mailing Address - Fax:434-395-2568
Practice Address - Street 1:201 HIGH STREET-ATHLETICS
Practice Address - Street 2:LONGWOOD UNIVERSITY
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901
Practice Address - Country:US
Practice Address - Phone:434-395-2017
Practice Address - Fax:434-395-2568
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260009372255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer