Provider Demographics
NPI:1376216457
Name:CASAZZA, CAITLIN NICOLE (KINESIOLOGIST)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:NICOLE
Last Name:CASAZZA
Suffix:
Gender:F
Credentials:KINESIOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:1000 NEW HOLLAND WAY NE APT 1326
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-0002
Mailing Address - Country:US
Mailing Address - Phone:336-906-8975
Mailing Address - Fax:
Practice Address - Street 1:2022 WINDWARD LN STE B
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-7418
Practice Address - Country:US
Practice Address - Phone:470-252-6710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist
No224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist