Individual
KORI LYNN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
8290 NEW ASHCAKE RD, MECHANICSVILLE, VA 23116-4033
(804) 723-3660
Mailing address
200 BERKLEY ST, ASHLAND, VA 23005-1329
(804) 365-4500
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119008543
VA
Other
Enumeration date
08/06/2021
Last updated
08/25/2023
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