Individual
KIM ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
2987 WILLOWRUN DR, CASTLE ROCK, CO 80109-7987
(512) 576-3312
Mailing address
2987 WILLOWRUN DR, CASTLE ROCK, CO 80109-7987
(512) 576-3312
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
0013873
CO
225200000X
Physical Therapy Assistant
Primary
2046043
TX
Other
Enumeration date
02/10/2007
Last updated
08/12/2016
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