Individual
CARISSA FUMAROLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
11123 MONTGOMERY RD STE 100, CINCINNATI, OH 45249-2390
(513) 469-6400
Mailing address
9604 DEER TRACK RD, WEST CHESTER, OH 45069-7046
(812) 221-5399
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000051258
BOCATC
—
Enumeration date
06/05/2022
Last updated
06/05/2022
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