Individual
MRS. KATHERINE ELLENWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3698 COTSWOLD AVE, 3C, GREENSBORO, NC 27410-9634
(336) 402-4292
Mailing address
3698 COTSWOLD AVE, 3C, GREENSBORO, NC 27410-9634
(336) 402-4292
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
6180
NC
Other
Enumeration date
02/09/2017
Last updated
02/09/2017
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