Carissa Lewallen, ATC
NPI #1144884677 in Ontario, California
Provider Information
- NPI Number
- 1144884677
- Entity Type
- Individual
- Name
- Carissa Lewallen, ATC
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- ATC
- Enumeration Date
- Apr 30, 2019
- Last Updated
- Apr 30, 2019
Practice Location
- Address
- 614 E J ST
- City
- Ontario
- State
- California
- ZIP Code
- 91764-2820
- Phone
- (909) 576-6427
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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