Individual
MARY ALICE EZZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1025 VERDAE BLVD, STE E, GREENVILLE, SC 29607-4032
(864) 286-7480
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3570
SC
Other
Enumeration date
02/22/2010
Last updated
11/06/2015
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