Individual
ELLEN PYEATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 MILLS ST, BROOKHAVEN, MS 39601-2521
(601) 250-4815
Mailing address
1369 AUBURN DR SW, BOGUE CHITTO, MS 39629-8262
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA3533
MS
Other
Enumeration date
10/17/2008
Last updated
10/17/2008
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