Individual
MARC CASTELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 SAGEWOOD DR, WINTERVILLE, GA 30683-1563
(706) 742-5758
(678) 254-1791
Mailing address
150 SAGEWOOD DR, WINTERVILLE, GA 30683-1563
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT005958
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000818254B
—
GA
Enumeration date
01/14/2010
Last updated
01/14/2010
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