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Individual

MR. RAYMOND WADE RANSOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC, PTA

Contact information

Practice address
400 S ORANGE AVE, RECREATION CENTER, SOUTH ORANGE, NJ 07079-2646
(973) 313-6394
Mailing address
66 PLEASANTVIEW DR, APT. A, PISCATAWAY, NJ 08854-3446
(732) 424-6410

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00190100
NJ
2255A2300X
Athletic Trainer
25MT00138700
NJ

Other

Enumeration date
05/02/2007
Last updated
09/11/2025
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