Individual
MRS. MARYANN MAUDE ELLERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
805 WEST AVE, BIG RAPIDS, MI 49307-9274
(231) 796-3185
Mailing address
PO BOX 412, LAKE GEORGE, MI 48633-0412
(989) 539-4937
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
05/29/2007
Last updated
07/08/2007
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