Individual
JENNIFER JAN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2699 LEE RD, SUITE 100, WINTER PARK, FL 32789-1753
(407) 897-1363
Mailing address
1340 LAKE ROGERS CIR, OVIEDO, FL 32765-7217
(407) 897-1363
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 1049
FL
Other
Enumeration date
09/22/2011
Last updated
09/22/2011
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