Individual
CARL ANTHONY LANGE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
424 W COLLINGS AVE, COLLINGSWOOD, NJ 08108-3054
(856) 261-4309
Mailing address
424 W COLLINGS AVE, COLLINGSWOOD, NJ 08108-3054
(856) 261-4309
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
MT000985
NJ
Other
Enumeration date
04/04/2018
Last updated
04/04/2018
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