Organization
SOUL TO SOLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA ELLIS LMT (MASSOTHERAPIST)
(614) 800-3794
Entity
Organization
Contact information
Practice address
6040 CLEVELAND AVE, COLUMBUS, OH 43231-2230
(614) 890-7952
(614) 890-8960
Mailing address
7703 COLUMBUS RD, MOUNT VERNON, OH 43050-9327
(614) 800-3791
(614) 890-8960
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
33.020787E-G
OH
Other
Enumeration date
01/15/2016
Last updated
01/15/2016
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