Individual
AMIE JO ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
433 OBETZ RD, COLUMBUS, OH 43207-4098
(740) 801-1204
Mailing address
117 1ST ST, ROCK SPRINGS, WY 82901-6140
(740) 801-1204
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
011100
OH
225200000X
Physical Therapy Assistant
Primary
0950
WY
Other
Enumeration date
02/20/2018
Last updated
04/08/2019
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