Philip Jason Mazzei, LAT, ATC
Specialist/Technologist, Athletic Trainer in Altoona, WI. Individual provider (NPI-1).
NPI number1144784331
StatusActive
Last updated in NPPESSep 11, 2020
Details
- NPI
- 1144784331
- Entity type
- Individual (NPI-1)
- Name
- Philip Jason Mazzei
- Credential
- LAT, ATC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 22, 2019
- Certification date
- Sep 11, 2020
- Last updated
- Sep 11, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 2270-39 | WI | Yes |
Practice location
1200 Oakleaf Way # AAltoona, WI 54720-2245
Phone 800-322-1747
Mailing address
1519 Glades DrAltoona, WI 54720-2539
Phone 715-456-9109
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