Individual
COURTNEY JEAN DEFEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2-22 BANTA PL, FAIR LAWN, NJ 07410-3058
(201) 509-8600
Mailing address
2-22 BANTA PL, FAIR LAWN, NJ 07410-3058
(201) 509-8600
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00328800
NJ
Other
Enumeration date
07/04/2024
Last updated
07/04/2024
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