Individual
CHERYL LEIGH ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1305 DANTIGNAC ST, AUGUSTA, GA 30901-2774
(706) 823-3807
(706) 823-3810
Mailing address
1305 DANTIGNAC ST, AUGUSTA, GA 30901-2774
(706) 823-3807
(706) 823-3810
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT000854
GA
Other
Enumeration date
01/23/2009
Last updated
01/23/2009
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