Individual
MICHELLE VANTASSEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
220 OAKLEY DR APT 19, COLUMBUS, GA 31906-4683
(605) 200-0144
Mailing address
220 OAKLEY DR APT 19, COLUMBUS, GA 31906-4683
(605) 200-0144
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/01/2017
Last updated
04/17/2023
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