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Individual

MR. SAMMY DAVID ELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MASSAGE THERAPIST

Contact information

Practice address
8302 NW 75TH AVE, TAMARAC, FL 33321-4833
(954) 240-1927
Mailing address
8302 NW 75TH AVE, TAMARAC, FL 33321-4833
(954) 240-1927

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
MA24715
FL

Other

Enumeration date
02/23/2013
Last updated
02/23/2013
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