Individual
DYLAN CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT,ATC
Contact information
Practice address
13 GOLDSMITH DR, SPOTSWOOD, NJ 08884-1032
(908) 239-9392
Mailing address
13 GOLDSMITH DR, SPOTSWOOD, NJ 08884-1032
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00242600
NJ
Other
Enumeration date
08/19/2017
Last updated
08/19/2017
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