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NPI Code Detail

MEDICARE: MRS. VANNASSA ZONTENNIA CASTON LPTA

MEDICARE: MRS. VANNASSA ZONTENNIA CASTON LPTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant2306001611VA

General Provider Information

NPI Number : 1043200660
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. VANNASSA ZONTENNIA CASTON LPTA
Provider Business Mailing Address
First Line : 201 JOSHUA CIR
Second Line :
City : SMITHFIELD
State : VA
Zip : 23430-1653
Country : US
Telephone Number : 757-357-7087
Fax Number :
Provider Business Practice Location Address
First Line : 576 JEFFERSON AVE
Second Line :
City : FORT EUSTIS
State : VA
Zip : 23604-1602
Country : US
Telephone Number : 757-314-7666
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2005
Last Update Date : 07/08/2007

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Directions to “ MRS. VANNASSA ZONTENNIA CASTON LPTA” Practice Location

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