Individual
JENNIFER EZELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16405 NORTHCROSS DR STE G2, HUNTERSVILLE, NC 28078-5005
(704) 439-3406
Mailing address
16405 NORTHCROSS DR STE G2, HUNTERSVILLE, NC 28078-5005
(704) 439-3406
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1974
SC
Other
Enumeration date
11/11/2009
Last updated
11/11/2009
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