NPI 1457088700

Jessica Taylor Dedomenico, MSLATATC

Practitioner Athletic Trainer Brick, NJ

Practice location

Address: 110 Cartagena Dr, Brick, NJ 08723-7005
Phone: (609) 495-5899
Mailing address: 457 Cr-64, Brick, NJ 08724

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 25MT00307100 (NJ)

Other Specialist/Technologist providers in New Jersey →

Registry record

NPI: 1457088700
Entity type: Individual
Sex (as registered): Female
NPI issued: 5 Aug 2022
Record last updated: 5 Aug 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.