Individual
DANIEL DESHONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
613 PARK AVE, PORT MONMOUTH, NJ 07758-1616
(201) 401-7311
Mailing address
613 PARK AVE, PORT MONMOUTH, NJ 07758-1616
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00197800
NJ
Other
Enumeration date
07/07/2014
Last updated
07/07/2014
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