NPI 1568585362

Eileen Wallace, ATCPTA

Practitioner Athletic Trainer Long Branch, NJ

Practice location

Address: 10 Arthur Ave, Long Branch, NJ 07740-6402
Phone: (732) 222-3839

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 25MT00040000 (NJ)

Other Specialist/Technologist providers in New Jersey →

Registry record

NPI: 1568585362
Entity type: Individual
Sex (as registered): Female
NPI issued: 8 Apr 2007
Record last updated: 21 Jul 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.