Individual
ELLIE MARTINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1850 TOWN CENTER PKWY UNIT 400303, RESTON, VA 20190-3204
(703) 277-2663
Mailing address
5116 HART MILL DR, GLEN ALLEN, VA 23060-6385
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110009236
VA
Other
Enumeration date
03/16/2023
Last updated
03/16/2023
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