Individual
MR. CARL ADRIAN PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.T.C.
Contact information
Practice address
467 FRANKLIN ST, BLOOMFIELD, NJ 07003-3425
(973) 748-9000
Mailing address
144 MOUNTAINSIDE DR, POMPTON LAKES, NJ 07442-1757
(973) 616-4872
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00112000
NJ
Other
Enumeration date
06/04/2007
Last updated
07/08/2007
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