MEDICARE: MS. CHALISA LOUISE FONZA M.A., ATC

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
1	2255A2300X	Athletic Trainer	AT-000718	OH

General Provider Information

NPI Number	:	1295948362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHALISA LOUISE FONZA M.A., ATC

Provider Business Mailing Address
First Line	:	2833 MARBLEWOOD DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-5038
Country	:	US
Telephone Number	:	614-688-5890
Fax Number	:	614-292-3258

Provider Business Practice Location Address
First Line	:	2833 MARBLEWOOD DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-5038
Country	:	US
Telephone Number	:	614-688-5890
Fax Number	:	614-292-3258

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	07/08/2007

Similar Medicare Providers

1770740201 — OPTIMUM NUTRITION CENTER, INC
Practice Location Address:

4923 ARMOUR RD STE 200
COLUMBUS, GA
31904-5038

Practice Phone: 800-351-6659
Practice Fax: 706-322-1804

1225317993 — MISS CEMINTHIA JENEA GRAHAM LCSW
Practice Location Address:

4923 ARMOUR RD STE 200
COLUMBUS, GA
31904-5038

Practice Phone: 706-940-2590
Practice Fax:

1598364093 — CHOSEN GENERATION COUNSELING AND CONSULTING, LLC
Practice Location Address:

4923 ARMOUR RD STE 200
COLUMBUS, GA
31904-5038

Practice Phone: 706-940-2590
Practice Fax:

1497499669 — KATHRYN ALEXIS ROOMA MSN RN
Practice Location Address:

420 N JAMES RD
COLUMBUS, OH
43219-1834

Practice Phone: 614-257-5200
Practice Fax:

1669328761 — ERIN BENDER RN
Practice Location Address:

420 N JAMES RD
COLUMBUS, OH
43219-1834

Practice Phone: 614-257-5200
Practice Fax:

1861199697 — KRISTI RAE POLING RN, BSN
Practice Location Address:

420 N JAMES RD
COLUMBUS, OH
43219-1834

Practice Phone: 614-257-5200
Practice Fax:

Directions to “ MS. CHALISA LOUISE FONZA M.A., ATC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.