Individual
ELLEN THERESE EGERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
906 TRAILVIEW BLVD SE, LEESBURG, VA 20175-4415
(703) 777-0528
Mailing address
4321 DONNA MARIE CT, HAYMARKET, VA 20169-1746
(703) 777-0528
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2305002834
VA
Other
Enumeration date
07/20/2006
Last updated
07/08/2007
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