Individual
JONATHAN EDWARD DICANDILO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS
Contact information
Practice address
324 HIGHLAND RD, POTTSTOWN, PA 19464-4408
(610) 705-0630
Mailing address
324 HIGHLAND RD, POTTSTOWN, PA 19464-4408
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT002231A
PA
Other
Enumeration date
11/14/2011
Last updated
11/14/2011
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