Individual
DR. MARISA ANNE COLSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, ATC
Contact information
Practice address
615 MCCALLIE AVE, DEPT. 6606, CHATTANOOGA, TN 37403-2504
(423) 425-4743
Mailing address
615 MCCALLIE AVE, DEPT. 6606, CHATTANOOGA, TN 37403-2504
(423) 425-4743
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
511
TN
Other
Enumeration date
09/09/2016
Last updated
09/09/2016
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