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1659783868
MARISSA VANE
BOSTON, MA
NPI
1659783868
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MA 2446)
Enumeration Date
2014-05-21
Last Update Date
2014-08-08
Business Address
-- MARISSA VANE ATC, LAT
1419 COMMONWEALTH AVE APARTMENT 504
BOSTON, MA 02135-6253
Phone number: 408-398-5578
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Mailing Address
-- MARISSA VANE ATC, LAT
100 ENDICOTT ST #3
BOSTON, MA 02113-1668
Phone number: 408-398-5578
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