Individual
TIMOTHY O'DONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
301 2ND AVE, HADDON HEIGHTS, NJ 08035-1407
(856) 547-1920
Mailing address
1139 NEWTON AVE, OAKLYN, NJ 08107-1067
(609) 870-0104
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00114200
NJ
Other
Enumeration date
04/03/2020
Last updated
04/03/2020
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