Individual
ZACHARY FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
601 HEMLOCK DR, NEWTON, NJ 07860-6770
(862) 268-0968
Mailing address
601 HEMLOCK DR, NEWTON, NJ 07860-6770
(862) 268-0968
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00192100
NJ
Other
Enumeration date
01/05/2016
Last updated
01/05/2016
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