Individual
LILLIAN ELISE ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19189 OH STATE ROUTE 136, WINCHESTER, OH 45697
(937) 695-0839
Mailing address
10133 FINCASTLE WINCHESTER RD, WINCHESTER, OH 45697-9495
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006628
KY
225100000X
Physical Therapist
PT015118
OH
Other
Enumeration date
02/19/2020
Last updated
02/19/2020
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