Individual
WILLIAM ELBERT JENNISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 CONFEDERATE POINT RD, PALATKA, FL 32177-8552
(386) 326-6298
Mailing address
110 CONFEDERATE POINT RD, PALATKA, FL 32177-8552
(386) 326-6298
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023848800
—
FL
Enumeration date
01/02/2019
Last updated
04/03/2019
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