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General NPI Number Information
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NPI Number | 1164014569
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Entity Type | Individual
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Provider Name | ELYSE FRANCO MS, LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 02/07/2021
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Last Update Date | 11/09/2022
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Provider Practice Location Address
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Address Line | 9601 GERMANTOWN AVE # 20
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City | PHILADELPHIA
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State | PA
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Zip | 19118-2693
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Country | US
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Telephone | 215-753-3666
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Fax |
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Provider Business Mailing Address
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Address Line | 8201 HENRY AVE APT S5
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City | PHILADELPHIA
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State | PA
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Zip | 19128-2255
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Country | US
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Telephone | 484-767-9235
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State | PA
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