Individual
MR. CORY ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
248 STATE STREET, BREWER, ME 04412
(207) 989-2034
(207) 989-5971
Mailing address
248 STATE ST, BREWER, ME 04412-1519
(207) 989-2034
(207) 989-5971
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PA3258
ME
Other
Enumeration date
05/27/2011
Last updated
05/27/2011
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