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Individual

MR. FOTI EVANGELISTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC, CAT(C), AT

Contact information

Practice address
2801 W. BANCROFT ST., HEALTH AND HUMAN SERVICES RM 2505L, MAIL STOP 119, TOLEDO, OH 43606-3390
(419) 530-4241
Mailing address
691 PIERRE STREET, LAVAL, QUEBEC H7X3P-4

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2-5536
ZZ
2255A2300X
Athletic Trainer
Primary
2000034460
2255A2300X
Athletic Trainer
AT006015
OH

Other

Enumeration date
04/03/2019
Last updated
10/23/2019
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