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MRS. JENNIFER RENEE CARLISLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
76 OSPREY VILLAGE DR, AMELIA ISLAND, FL 32034-4962
(904) 491-1701
(904) 491-1702
Mailing address
76 OSPREY VILLAGE DR, AMELIA ISLAND, FL 32034
(904) 491-1701
(904) 491-1702

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA20378
FL

Other

Enumeration date
04/07/2009
Last updated
04/07/2009
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