Individual
SHANNON ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7413 E HUNTINGTON DR, BOARDMAN, OH 44512-8001
(330) 301-4927
Mailing address
7413 E HUNTINGTON DR, BOARDMAN, OH 44512-8001
(330) 301-4927
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
OH
Other
Enumeration date
09/06/2014
Last updated
09/06/2014
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