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Individual

ELLEN JOY BASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
319 W TOWN PL, SUITE 5, SAINT AUGUSTINE, FL 32092-3101
(904) 342-5262
(904) 217-3580
Mailing address
319 W TOWN PL, SUITE 5, SAINT AUGUSTINE, FL 32092-3101
(904) 342-5262
(904) 217-3580

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT28019
FL

Other

Enumeration date
02/11/2013
Last updated
02/11/2013
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