Individual
JESSE TRISTIAN LEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
5 CARMELLO DR, EDISON, NJ 08817-3025
(732) 991-6678
Mailing address
5 CARMELLO DR, EDISON, NJ 08817-3025
(732) 991-6678
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00281700
NJ
Other
Enumeration date
12/03/2020
Last updated
12/03/2020
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