Individual
AMY ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1000 ASSOCIATION DR, CHARLESTON, WV 25311-1270
(304) 347-4372
Mailing address
306 LIVERPOOL RD, REEDY, WV 25270-9576
(304) 927-2618
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002632
WV
Other
Enumeration date
06/20/2007
Last updated
07/08/2007
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