Individual
NICHOLAS ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8701 64TH ST N, PINELLAS PARK, FL 33782-4704
(727) 204-7911
Mailing address
8701 64TH ST N, PINELLAS PARK, FL 33782-4704
(727) 204-7911
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
12/28/2022
Last updated
12/28/2022
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