Individual
ALICIA ELLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPO, LPO
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
OPP00269
AR
224P00000X
Prosthetist
OPP00269
AR
Other
Enumeration date
05/17/2017
Last updated
07/21/2022
Update your record
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