Individual
TOM THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, EMT
Contact information
Practice address
39 ORCHARD PL, MAYWOOD, NJ 07607-1835
(201) 314-2481
Mailing address
39 ORCHARD PL, MAYWOOD, NJ 07607-1835
(201) 314-2481
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00128900
NJ
Other
Enumeration date
12/06/2006
Last updated
07/08/2007
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