Individual
AMY L ELLINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3200 NORTHLINE AVE, STE 160, GREENSBORO, NC 27408-7602
(336) 545-5000
(336) 545-5020
Mailing address
PO BOX 38008, GREENSBORO, NC 27438-8008
(336) 545-5000
(336) 545-5020
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10003
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q36454A
MEDICARE PTAN
NC
Enumeration date
11/08/2005
Last updated
08/02/2011
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