| NPI | 1104515303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DYLAN CHURCH General Partner 732-783-4973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Enumeration Date | 2023-05-03 |
| Last Update Date | 2023-05-03 |