Provider Demographics
NPI:1164014569
Name:FRANCO, ELYSE (MS, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:ELYSE
Middle Name:
Last Name:FRANCO
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 HENRY AVE APT S5
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-2255
Mailing Address - Country:US
Mailing Address - Phone:484-767-9235
Mailing Address - Fax:
Practice Address - Street 1:9601 GERMANTOWN AVE # 20
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-2693
Practice Address - Country:US
Practice Address - Phone:215-753-3666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-07
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA390200000X, 2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program