Individual
ELIJAH CASTANUELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1218 HIGHWAY 112, EASTLAND, TX 76448-5415
(325) 733-2459
Mailing address
1218 HIGHWAY 112, EASTLAND, TX 76448-5415
(325) 733-2459
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
TX
Other
Enumeration date
07/04/2022
Last updated
05/22/2024
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