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Individual

JENNY ELLISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2415 SUMMITVIEW AVE, YAKIMA, WA 98902-2347
(850) 377-3196
Mailing address
8820 DESERT FOX WAY NE, ALBUQUERQUE, NM 87122-3647

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5764
NM
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/19/2017
Last updated
09/07/2021
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