Individual
STACY ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
455 BRAYTON AVE, SOMERSET, MA 02726-2642
(508) 679-2240
Mailing address
PO BOX 9242, FALL RIVER, MA 02720-0005
(774) 319-7930
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2826
MA
Other
Enumeration date
08/25/2015
Last updated
08/25/2015
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