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Individual

MRS. MALLIE ELLISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
425 5TH AVE NW, ATTALLA, AL 35954-2214
(256) 538-2273
(256) 538-9373
Mailing address
1007 GOODYEAR AVE, GADSDEN, AL 35903-1195
(256) 538-2273
(256) 538-9373

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH1575
AL

Other

Enumeration date
03/02/2007
Last updated
07/08/2007
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