Individual
RACHEL DAWN ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1300 BLOOMINGDALE PIKE, KINGSPORT, TN 37660-2685
(865) 531-2204
Mailing address
161 TREADWAY DR, JOHNSON CITY, TN 37601-6229
(423) 794-0958
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3716
TN
Other
Enumeration date
01/20/2015
Last updated
01/20/2015
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