Individual
MISS REBECCA ENSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
63 LEE ST, WINDER, GA 30680-2016
(678) 425-0718
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(610) 444-6350
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA003645
GA
Other
Enumeration date
03/20/2017
Last updated
03/20/2017
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