Susan Marie Anzalone, ATC
Specialist/Technologist, Athletic Trainer in Springfield, MO. Individual provider (NPI-1).
NPI number1710286117
StatusActive
Last updated in NPPESMar 24, 2011
Details
- NPI
- 1710286117
- Entity type
- Individual (NPI-1)
- Name
- Miss Susan Marie Anzalone
- Credential
- ATC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 24, 2011
- Last updated
- Mar 24, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 2011005758 | MO | Yes |
Practice location
901 S National AveSpringfield, MO 65897-0027
Phone 417-836-5461
Mailing address
2601 N Cresthaven AveH206
Springfield, MO 65803-7826
Phone 314-494-1304
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