Provider Demographics
NPI:1922061357
Name:ISNER, ELIZABETH WILLIAMS (ATC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:WILLIAMS
Last Name:ISNER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 CROSSING CT
Mailing Address - Street 2:APT 204
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-6235
Mailing Address - Country:US
Mailing Address - Phone:757-227-3337
Mailing Address - Fax:
Practice Address - Street 1:829 CROSSING CT
Practice Address - Street 2:APT 204
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6235
Practice Address - Country:US
Practice Address - Phone:757-227-3337
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260009542255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer