Individual
LYNN MARIE ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
7598 DURHAM RD, WHITEHALL, MI 49461-9513
(231) 730-5348
Mailing address
7598 DURHAM RD, WHITEHALL, MI 49461-9513
(231) 730-5348
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202007777
MI
Other
Enumeration date
06/09/2019
Last updated
06/09/2019
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