Individual
MACKENZIE CASTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
1500 UNIVERSITY AVE, MORGANTOWN, WV 26506
(304) 293-0111
Mailing address
511 BURROUGHS ST APT 205, MORGANTOWN, WV 26505-3390
(910) 309-9024
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001792
WV
Other
Enumeration date
09/02/2021
Last updated
09/02/2021
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