Individual
MR. DANIEL ALEXANDER ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
801 N. HAMILTON ST., WILLIAMSTON, SC 29697
(864) 847-7344
Mailing address
530 CLARENDON DR., EASLEY, SC 29642
(864) 423-2446
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2684
SC
Other
Enumeration date
05/13/2014
Last updated
05/13/2014
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