Individual
ELYSE MACKENZIE WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
232 PONTE VEDRA PARK DR, PONTE VEDRA, FL 32082-6600
(904) 634-0640
(904) 634-0203
Mailing address
913 2ND ST S APT 306, JACKSONVILLE BEACH, FL 32250-6578
(850) 345-0902
(850) 345-0902
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT36038
FL
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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