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Individual
DOUG PADRON
Active
Individual
DOUG PADRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
089702581
NJ
390200000X
Student in an Organized Health Care Education/Training Program
089702381
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
089702581
CERTIFICATION NUMBER
NJ
Enumeration date
07/02/2008
Last updated
07/02/2008
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