Individual
ELISE GENET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25383 COLE ST, LOMA LINDA, CA 92354-3103
(909) 796-0235
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
47893
CA
Other
Enumeration date
01/31/2023
Last updated
01/31/2023
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