Individual
FREDERIC JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS, USAW
Contact information
Practice address
467 FRANKLIN ST, BLOOMFIELD, NJ 07003-3494
(973) 748-9000
Mailing address
70B FREMONT ST APT 15B, BLOOMFIELD, NJ 07003-3464
(201) 303-1214
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00159700
NJ
Other
Enumeration date
09/06/2019
Last updated
09/06/2019
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