Individual
ANTONIO CARRASCO II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSCS
Contact information
Practice address
5327 W EDGEMONT AVE, PHOENIX, AZ 85035-1917
(623) 313-8793
Mailing address
5327 W EDGEMONT AVE, PHOENIX, AZ 85035-1917
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/16/2019
Last updated
01/16/2019
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