Individual
KIM SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
404 INDIANA AVE, ATHLETICS DEPARTMENT, LONG BRANCH, NJ 07740-6122
(732) 229-7300
Mailing address
404 INDIANA AVE, ATHLETICS DEPARTMENT, LONG BRANCH, NJ 07740-6122
(732) 229-7300
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00187400
NJ
Other
Enumeration date
06/03/2014
Last updated
03/09/2015
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