Individual
TAMMY RENEE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
33875 KIELY DR, CHESTERFIELD, MI 48047-3604
(586) 725-6030
Mailing address
3642 PALMS RD, CASCO, MI 48064-2103
(586) 477-8618
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502002187
MI
Other
Enumeration date
10/10/2024
Last updated
10/10/2024
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