Individual
MISS TIFFANY ANNE WHALEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
900 LAKEWOOD AVE, OFFICE OF ATHLETIC TRAINING, LAKEWOOD, NJ 08701-2600
(732) 987-2687
(732) 987-2031
Mailing address
900 LAKEWOOD AVE, OFFICE OF ATHLETIC TRAINING, LAKEWOOD, NJ 08701-2600
(732) 987-2687
(732) 987-2031
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00166400
NJ
Other
Enumeration date
09/27/2010
Last updated
01/18/2017
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