Khalif Dubose, MS LAT ATC
Specialist/Technologist, Athletic Trainer in North Brunswick, NJ. Individual provider (NPI-1).
NPI number1194473363
StatusActive
Last updated in NPPESMar 16, 2022
Details
- NPI
- 1194473363
- Entity type
- Individual (NPI-1)
- Name
- Khalif Dubose
- Credential
- MS LAT ATC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 16, 2022
- Certification date
- Mar 16, 2022
- Last updated
- Mar 16, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 25MT00303800 | NJ | Yes |
Practice location
1133 Livingston Ave Apt 9North Brunswick, NJ 08902-3807
Phone 732-470-7309
Mailing address
1133 Livingston Ave Apt 9North Brunswick, NJ 08902-3807
Phone 732-470-7309
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