Individual
GUY D. MIDURE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
625 BREAKNECK RD, MULLICA HILL, NJ 08062-2421
(856) 223-2778
Mailing address
210 S 3RD ST, WATERFORD WORKS, NJ 08089-2230
(856) 768-3693
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
MT00807
NJ
Other
Enumeration date
08/25/2006
Last updated
07/08/2007
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