Individual
MARISSA CASANOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 MEDICAL PARK BLVD, PETERSBURG, VA 23805-9274
(804) 765-5000
Mailing address
1650 OVERBROOK RD APT D3, RICHMOND, VA 23220-1303
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110009311
VA
Other
Enumeration date
02/08/2021
Last updated
08/11/2023
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