Individual
EHREN L. ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4308 HANOVER PARK DR, JACKSONVILLE, FL 32224-8602
(904) 955-3103
Mailing address
4308 HANOVER PARK DR, JACKSONVILLE, FL 32224-8602
(904) 955-3103
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
EXEMPT
FL
225100000X
Physical Therapist
Primary
PT19154
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000469100
—
FL
05
—
886160900
—
FL
Enumeration date
02/22/2006
Last updated
05/20/2013
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