Individual
JESSICA TAYLOR DEDOMENICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,LAT, ATC
Contact information
Practice address
110 CARTAGENA DR, BRICK, NJ 08723-7005
(609) 495-5899
Mailing address
457 CR-64, BRICK, NJ 08724
(732) 800-9000
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00307100
NJ
Other
Enumeration date
08/05/2022
Last updated
08/05/2022
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