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Individual

SHAWN ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
430 CLAIRMONT CT STE 120, COLONIAL HEIGHTS, VA 23834-1770
(804) 526-1352
Mailing address
430 CLAIRMONT CT STE 120, COLONIAL HEIGHTS, VA 23834-1770

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306605165
VA

Other

Enumeration date
07/15/2021
Last updated
07/15/2021
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