Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1376216457 |
---|---|
Provider Name | Caitlin Nicole Casazza |
First Address | Gainesville, GA 30501-0002 |
Second Address | Gainesville, GA 30501-7418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2021 |
Last Update Date | 26/07/2021 |