Individual
MISS CALLISTA ANASTASIA MANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
640 NANAK CT, NAPERVILLE, IL 60565-3365
(630) 240-5350
Mailing address
640 NANAK CT, NAPERVILLE, IL 60565-3365
(630) 240-5350
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/31/2019
Last updated
03/07/2021
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