Provider Demographics
NPI:1912934548
Name:KRAMER, ELISE MARIE (MS, ATC/L)
Entity Type:Individual
Prefix:
First Name:ELISE
Middle Name:MARIE
Last Name:KRAMER
Suffix:
Gender:F
Credentials:MS, ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 N FOWLER AVE APT 252
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-6877
Mailing Address - Country:US
Mailing Address - Phone:559-389-1979
Mailing Address - Fax:
Practice Address - Street 1:5305 N CAMPUS DR
Practice Address - Street 2:NG 27
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93740-0001
Practice Address - Country:US
Practice Address - Phone:559-278-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer