Individual
JAIME ELLEBRACHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
872 COLLEGE BLVD, OSAGE BEACH, MO 65065-8408
(573) 302-0900
Mailing address
1505 36TH STREET LN, SEDALIA, MO 65301-8868
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
392311
MO
Other
Enumeration date
08/30/2018
Last updated
02/05/2025
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