Individual
ELLYSE JOHNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
95 MEDICAL PARK BLVD, PETERSBURG, VA 23805-9280
(804) 504-8100
(804) 504-7795
Mailing address
95 MEDICAL PARK BLVD, PETERSBURG, VA 23805-9280
(804) 504-8100
(804) 504-7795
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305207547
VA
Other
Enumeration date
11/07/2014
Last updated
11/07/2014
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