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1467640474
WANDA GAYLE ELLISON
SOUTH DAYTONA, FL
NPI
1467640474
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Former Name
WANDA GAYLE ELLISON
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: PTA479)
Enumeration Date
2007-10-04
Last Update Date
2007-10-04
Business Address
WANDA GAYLE ELLISON LPTA
681 BEVILLE RD
SOUTH DAYTONA, FL 32119-1951
Phone number: 800-330-7711
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Mailing Address
WANDA GAYLE ELLISON LPTA
681 BEVILLE RD
SOUTH DAYTONA, FL 32119-1951
Phone number: 800-330-7711
Copy
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