Individual
MR. RONNIE LEE CHASTAIN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
538 VENARD RD, CLARKS SUMMIT, PA 18411-1250
(570) 585-9326
(570) 585-9336
Mailing address
538 VENARD RD, CLARKS SUMMIT, PA 18411-1250
(570) 585-9156
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT003598
PA
Other
Enumeration date
07/20/2006
Last updated
07/08/2007
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