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General NPI Number Information
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NPI Number | 1376216457
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Entity Type | Individual
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Provider Name | CAITLIN NICOLE CASAZZA KINESIOLOGIST
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Gender | Female
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Dates
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Enumeration Date | 07/26/2021
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Last Update Date | 07/26/2021
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Provider Practice Location Address
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Address Line | 2022 WINDWARD LN STE B
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City | GAINESVILLE
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State | GA
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Zip | 30501-7418
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Country | US
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Telephone | 470-252-6710
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 NEW HOLLAND WAY NE APT 1326
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City | GAINESVILLE
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State | GA
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Zip | 30501-0002
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Country | US
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Telephone | 336-906-8975
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Y00000X
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Taxonomy Name | Clinical Exercise Physiologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 226300000X
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Taxonomy Name | Kinesiotherapist
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License Number |
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License Number State |
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