Individual
ELYSSA M ENRIQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4501 EMPIRE CT, FREDERICKSBURG, VA 22408-1949
(540) 371-0079
Mailing address
613 ROYER AVE NW, NORTH CANTON, OH 44720-2457
(330) 313-4114
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/25/2023
Last updated
07/25/2023
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