Individual
LISA ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
707 ELDRIDGE AVE E, WYNNE, AR 72396-4032
(870) 208-8989
(870) 208-8107
Mailing address
707 ELDRIDGE AVE E, WYNNE, AR 72396-4032
(870) 208-8989
(870) 208-8107
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA2267
AR
Other
Enumeration date
09/15/2008
Last updated
09/15/2008
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