Individual
THOMAS CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 CEDAR AVE, WEST LONG BRANCH, NJ 07764-1804
(732) 263-4473
Mailing address
68 PINEWOOD AVE, WEST LONG BRANCH, NJ 07764-1870
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00210500
NJ
Other
Enumeration date
08/04/2015
Last updated
08/04/2015
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