NPI 1104362359

Nicolette Julianne Carsillo, LATATC

Practitioner Athletic Trainer Valdosta, GA

Practice location

Address: 3527 N Valdosta Rd, Valdosta, GA 31602-6418
Phone: (229) 247-2290
Fax: (229) 247-9627

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence AT002863 (GA)

Other Specialist/Technologist providers in Georgia →

Registry record

NPI: 1104362359
Entity type: Individual
Sex (as registered): Female
NPI issued: 12 Jan 2017
Record last updated: 12 Jan 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.