Individual
DR. CARLY ANN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
2360 TOWNE LAKE PKWY, STE 104, WOODSTOCK, GA 30189-5576
(770) 516-7477
(770) 516-7493
Mailing address
2360 TOWNE LAKE PKWY, STE 104, WOODSTOCK, GA 30189-5576
(770) 516-7477
(770) 516-7493
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038-011692
IL
111N00000X
Chiropractor
Primary
CHIRO08782
GA
Other
Enumeration date
06/22/2010
Last updated
03/10/2011
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