Individual
MISS COLLEEN M RACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
400 CEDAR AVE, DEPARTMENT OF ATHLETICS, WEST LONG BRANCH, NJ 07764-1804
(732) 571-4473
Mailing address
400 CEDAR AVE, DEPARTMENT OF ATHLETICS, WEST LONG BRANCH, NJ 07764-1804
(732) 571-4473
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00163400
NJ
Other
Enumeration date
03/28/2011
Last updated
03/28/2011
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