Individual
SUZANNE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1900 MIDLAND TRL, SUITE 1 & 2, SHELBYVILLE, KY 40065-8141
(502) 633-1007
(502) 437-0624
Mailing address
1900 MIDLAND TRL, SUITE 1 & 2, SHELBYVILLE, KY 40065-8141
(502) 633-1007
(502) 437-0624
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A5549
KY
Other
Enumeration date
10/02/2013
Last updated
10/02/2013
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