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Individual

MR. JOHN M MELLODY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
1 JETS DR, NEW YORK JETS, LLC, FLORHAM PARK, NJ 07932-1215
(973) 549-4701
(973) 549-4708
Mailing address
1 JETS DR, NEW YORK JETS, LLC, FLORHAM PARK, NJ 07932-1215
(973) 549-4701
(973) 549-4708

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
000705-1
NY
2255A2300X
Athletic Trainer
Primary
25MT00096300
NJ

Other

Enumeration date
02/27/2006
Last updated
01/24/2013
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