Individual
JANE FIELDS ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
224D CORNWALL ST NW, SUITE 200, LEESBURG, VA 20176-2700
(703) 443-2223
(703) 443-2690
Mailing address
PO BOX 17334, BALTIMORE, MD 21297-1334
(703) 443-6717
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
230600042
VA
Other
Enumeration date
09/28/2011
Last updated
09/28/2011
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