Individual
AMY LOUISE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5100 S CLYDE MORRIS BLVD, SUITE 200, PORT ORANGE, FL 32127-8976
(386) 304-8112
(386) 304-8014
Mailing address
5100 S CLYDE MORRIS BLVD, SUITE 200, PORT ORANGE, FL 32127-8976
(386) 304-8112
(386) 304-8014
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3183
FL
Other
Enumeration date
08/13/2006
Last updated
07/08/2007
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