Individual
MR. MATTHEW RYAN BALE-PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS
Contact information
Practice address
25 OLCOTT AVE, BERNARDSVILLE, NJ 07924-2307
(908) 204-1930
Mailing address
7117 COVENTRY CT, RIVERDALE, NJ 07457-1643
(973) 831-2676
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00146300
NJ
Other
Enumeration date
09/30/2008
Last updated
09/30/2008
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