Individual
MS. SUSAN ANNE ELLIS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC, LAT, EMT
Contact information
Practice address
130 TUSKAWILLA RD, WINTER SPRINGS, FL 32708-2831
(407) 320-8749
Mailing address
411 MURPHY RD, WINTER SPRINGS, FL 32708-3497
(407) 252-4915
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL246
FL
Other
Enumeration date
04/27/2006
Last updated
07/08/2007
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