Individual
CASSIDY ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
306 LIBERTY VIEW LN, LYNCHBURG, VA 24502-2291
(434) 592-6400
Mailing address
1321 TEMPLETON MILL RD, LYNCHBURG, VA 24503-6484
(540) 834-9285
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/04/2025
Last updated
04/04/2025
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