Individual
ELLIE VICTORIA MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1305 BOILING SPRINGS RD, GREER, SC 29650-4139
(864) 458-7566
Mailing address
184 CAROLINA OAKS DR, FOUNTAIN INN, SC 29644-8506
(864) 612-0727
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4556
SC
Other
Enumeration date
12/25/2020
Last updated
12/25/2020
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