Provider Demographics
NPI:1558380147
Name:MENEGONI, SHARON (ATC)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:MENEGONI
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 1:1506 4TH AVE EXT
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901
Mailing Address - Country:US
Mailing Address - Phone:434-315-0006
Mailing Address - Fax:
Practice Address - Street 1:201 HIGH ST
Practice Address - Street 2:LONGWOOD UNIVERSITY
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23909-1800
Practice Address - Country:US
Practice Address - Phone:434-395-2845
Practice Address - Fax:434-395-2380
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260000282255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer