Individual
ELLIS BARRETT WINEPOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 S 29TH ST, FORT PIERCE, FL 34947-3626
(772) 465-7560
Mailing address
700 S 29TH ST, FORT PIERCE, FL 34947-3626
(772) 465-7560
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA28732
FL
Other
Enumeration date
09/10/2018
Last updated
09/10/2018
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