Individual
MARIO ANDRES CASALLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 45433-5529
(937) 257-8349
Mailing address
5971 HICKAM DR, DAYTON, OH 45431-1561
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/04/2021
Last updated
11/04/2021
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