Provider Demographics
NPI:1679549521
Name:MASCARO, CHRISTINA JEAN (ATC)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTINA
Middle Name:JEAN
Last Name:MASCARO
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3201 HARGROVE RD E
Mailing Address - Street 2:APT 3304
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-3438
Mailing Address - Country:US
Mailing Address - Phone:407-718-2351
Mailing Address - Fax:205-348-4419
Practice Address - Street 1:BOX 870393
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35487-0001
Practice Address - Country:US
Practice Address - Phone:205-348-4422
Practice Address - Fax:205-348-4419
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL8732255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer