Individual
BRYAN ALLEN ELLSBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
805 ON THE GRN, BILOXI, MS 39532-3229
(228) 365-8545
Mailing address
805 ON THE GRN, BILOXI, MS 39532-3229
(228) 365-8545
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1449
MS
Other
Enumeration date
06/11/2013
Last updated
06/22/2021
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