Provider Demographics
NPI:1770558124
Name:CASTELEIN, FARREN NIXON (ATC)
Entity type:Individual
Prefix:
First Name:FARREN
Middle Name:NIXON
Last Name:CASTELEIN
Suffix:
Gender:F
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:ASU SPORTS MEDICINE
Mailing Address - Street 2:PO BOX 872505
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85287-2505
Mailing Address - Country:US
Mailing Address - Phone:480-965-6389
Mailing Address - Fax:
Practice Address - Street 1:500 E. VETERANS WAY
Practice Address - Street 2:ASU SPORTS MEDICINE
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85287-2505
Practice Address - Country:US
Practice Address - Phone:480-965-6389
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ05272255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer