Individual
MS. MARY ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
128 MIDDLE ST, FARMINGTON, ME 04938-6937
(207) 778-6469
(207) 778-3486
Mailing address
128 MIDDLE ST, FARMINGTON, ME 04938-6937
(207) 778-6469
(207) 778-3486
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT868
ME
Other
Enumeration date
12/21/2012
Last updated
12/21/2012
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