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General NPI Number Information
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NPI Number | 1679549521
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Entity Type | Individual
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Provider Name | CHRISTINA JEAN MASCARO ATC
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Gender | Female
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Dates
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Enumeration Date | 02/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | BOX 870393
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City | TUSCALOOSA
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State | AL
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Zip | 35487-0001
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Country | US
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Telephone | 205-348-4422
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Fax | 205-348-4419
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Provider Business Mailing Address
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Address Line | 3201 HARGROVE RD E APT 3304
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City | TUSCALOOSA
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State | AL
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Zip | 35405-3438
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Country | US
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Telephone | 407-718-2351
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Fax | 205-348-4419
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 873
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License Number State | AL
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