Individual
MR. JAMES RYAN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
321 FLORA GENE AVE W STE D, WIGGINS, MS 39577-5010
(601) 523-1994
(601) 523-1995
Mailing address
321 FLORA GENE AVE W STE D, WIGGINS, MS 39577-5010
(601) 523-1994
(601) 523-1995
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA6404
MS
Other
Enumeration date
05/21/2018
Last updated
05/21/2018
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