Individual
CALISTA MARIE FASANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
620 BOWERS BLVD, HUNTSVILLE, TX 77341-0001
(936) 294-3532
Mailing address
2402 SYCAMORE AVE APT D7, HUNTSVILLE, TX 77340-6145
(425) 890-3945
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT9143
TX
Other
Enumeration date
09/15/2022
Last updated
09/15/2022
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