Provider Demographics
NPI:1396710141
Name:SHEERON, MEREDITH BARBARA (ATC)
Entity type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:BARBARA
Last Name:SHEERON
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 1:10532 FALKIRK WAY
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-6488
Mailing Address - Country:US
Mailing Address - Phone:703-426-1176
Mailing Address - Fax:703-426-1172
Practice Address - Street 1:9200 BURKE LAKE RD
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-1682
Practice Address - Country:US
Practice Address - Phone:703-426-1176
Practice Address - Fax:703-426-1172
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260000792255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer