Provider Demographics
NPI:1568136422
Name:CAROSELLI, ZACHARY RHODES (ATC)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:RHODES
Last Name:CAROSELLI
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 78
Mailing Address - Street 2:
Mailing Address - City:LEON
Mailing Address - State:IA
Mailing Address - Zip Code:50144-0078
Mailing Address - Country:US
Mailing Address - Phone:715-614-1442
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERSITY PL
Practice Address - Street 2:
Practice Address - City:LAMONI
Practice Address - State:IA
Practice Address - Zip Code:50140-1699
Practice Address - Country:US
Practice Address - Phone:641-784-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer