Individual
MRS. SHANNON LEIGH ELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
831 MCDOW DR, ROCK HILL, SC 29732-2415
(803) 326-3116
Mailing address
7200 MAPLERIDGE DR, CHARLOTTE, NC 28210-6512
(704) 777-9925
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
1401
NC
225200000X
Physical Therapy Assistant
Primary
1413
SC
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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