Individual
MRS. ILISSA L RAYMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
500 ACADEMY ST S, AHOSKIE, NC 27910-3248
(252) 209-3784
Mailing address
522 LOGAN ST, ELMIRA, NY 14901-1933
(607) 426-6159
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P12321
NC
Other
Enumeration date
02/10/2011
Last updated
02/10/2011
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