Individual
KATHARINE GRACE FISENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
10932 CHAMBERLAIN HALL CT, CHARLOTTE, NC 28277-1769
(980) 322-8842
Mailing address
10932 CHAMBERLAIN HALL CT, CHARLOTTE, NC 28277-1769
(980) 322-8842
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/08/2014
Last updated
06/28/2016
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