Individual
JOSEPH H KASUSKA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
19455 DEERFIELD AVE. SUITE 306, LANSDOWNE, VA 20176
(703) 729-5010
(703) 729-5833
Mailing address
14110 ROCKY VALLEY DR, CENTREVILLE, VA 20121
(484) 467-2889
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126003071
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7090975568
BOC OF ATHLETIC TRAINERS
VA
Enumeration date
08/01/2019
Last updated
08/01/2019
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