Individual
MAIKEE BERNADETTE MIGALLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
400 CEDAR AVE, WEST LONG BRANCH, NJ 07764-1804
(732) 263-4473
Mailing address
400 NORWOOD AVE, WEST LONG BRANCH, NJ 07764-1828
(973) 866-6663
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00214400
NJ
Other
Enumeration date
05/24/2018
Last updated
05/24/2018
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