Individual
FANTA KEITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1083 MEIXSELL VALLEY RD, SAYLORSBURG, PA 18353-8024
(929) 451-9380
Mailing address
1083 MEIXSELL VALLEY RD, SAYLORSBURG, PA 18353-8024
(929) 451-9380
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/16/2024
Last updated
09/16/2024
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