Individual
JONATHON ROERDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
12 RIDGEWAY DR, WARWICK, NY 10990-1222
(845) 325-7499
Mailing address
12 RIDGEWAY DR, WARWICK, NY 10990-1222
(845) 325-7499
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
00325
NY
Other
Enumeration date
12/01/2019
Last updated
12/01/2019
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