Individual
MELANIE ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
10533 GODDARD STREET, APT 331, OVERLAND PARK, KS 66214
(209) 872-0711
Mailing address
10533 GODDARD STREET, APT 331, OVERLAND PARK, KS 66214
(209) 872-0711
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2014024987
MO
2255A2300X
Athletic Trainer
24-00962
KS
Other
Enumeration date
10/23/2015
Last updated
10/23/2015
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