Individual
MRS. JENNIFER DAWN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS PT
Contact information
Practice address
629 S PLUMMER AVE, CHANUTE, KS 66720-1928
(620) 432-5378
Mailing address
1195 2000TH ST, IOLA, KS 66749-7056
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-03174
KS
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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