Individual
MRS. LAURIANN ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
801 S MAIN ST, CLINTON, IN 47842-2261
(765) 832-1233
(765) 832-1261
Mailing address
3398 W 200 S, DANA, IN 47847-8079
(765) 665-0095
(765) 832-1261
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06001526A
IN
Other
Enumeration date
02/21/2014
Last updated
02/21/2014
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