Individual
MCKENZIE ELYSE LILLIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
437A HIGHWAY 601 S, LUGOFF, SC 29078-8918
(803) 900-4020
Mailing address
1336 GARRISON RD, VINELAND, NJ 08360-6906
(609) 579-9799
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT.10512
SC
Other
Enumeration date
12/16/2020
Last updated
12/16/2020
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