Individual
JADON LEE DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 PROSPECT ST, EAST STROUDSBURG, PA 18301-2956
(484) 547-2626
Mailing address
5511 STONECROFT LN, ALLENTOWN, PA 18106-9177
(484) 547-2626
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT008443
PA
Other
Enumeration date
02/01/2024
Last updated
07/24/2024
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