Individual
ELLEN C NILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1300 VETERANS RD, WARRENSBURG, MO 64093-8294
(573) 581-1088
(573) 581-5356
Mailing address
PO BOX 383, WARSAW, MO 65355-0383
(573) 581-1088
(573) 581-5356
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2001019333
MO
Other
Enumeration date
02/03/2012
Last updated
02/03/2012
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