Individual
KATHLEEN ANNETTE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
426 S ALABAMA ST STE 200, INDIANAPOLIS, IN 46225-3301
(317) 528-6804
(317) 528-3781
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06002780A
IN
Other
Enumeration date
09/16/2024
Last updated
10/21/2024
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