Individual
CHARLES MARSHALL MOZENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
4700 POWHATAN AVENUE, NORFOLK, VA 23529-0001
(757) 683-3384
Mailing address
814 46TH ST APT A, NORFOLK, VA 23508-2010
(740) 213-4401
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
01260030039
VA
2255A2300X
Athletic Trainer
Primary
2000031468
—
Other
Enumeration date
08/23/2018
Last updated
08/23/2018
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