Individual
JUSTIN LEE HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC,LAT
Contact information
Practice address
150A TICES LN, EAST BRUNSWICK, NJ 08816-2015
(732) 838-7547
Mailing address
4 MUNDY RD, EAST BRUNSWICK, NJ 08816-2664
(848) 219-5527
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00314000
NJ
Other
Enumeration date
12/19/2022
Last updated
12/19/2022
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