Individual
ANGELA C ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, MPT
Contact information
Practice address
31 STAFFORD AVE, STAFFORD, VA 22554-7246
(540) 658-6500
Mailing address
5204 MCMANUS DR, FREDERICKSBURG, VA 22407-7773
(540) 710-6602
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
2305202133
VA
Other
Enumeration date
02/08/2018
Last updated
02/08/2018
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