Individual
MR. OZZIE ALEXANDER DIAZ
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
51 CONFORTI AVE, WEST ORANGE, NJ 07052-2829
(973) 669-5301
(973) 669-8605
Mailing address
115 LAUREL AVE, POMPTON LAKES, NJ 07442-2410
(973) 835-5858
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00066100
NJ
Other
Enumeration date
02/22/2006
Last updated
07/08/2007
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