Individual
GERI ANN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
326 E MAIN ST, WEST FRANKFORT, IL 62896-2402
(618) 847-0683
Mailing address
205 FREEMAN ST, ANNA, IL 62906-1505
(618) 697-2810
(618) 697-2810
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.004528
IL
Other
Enumeration date
10/27/2017
Last updated
10/27/2017
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