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1669438073
STACEY ELLIS
MANASSAS, VA
NPI
1669438073
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: VA 0126000571)
Enumeration Date
2006-04-25
Last Update Date
2007-07-08
Business Address
-- STACEY ELLIS
9005 TUDOR LN
MANASSAS, VA 20110-5754
Phone number: 703-257-8500
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Mailing Address
-- STACEY ELLIS
110 TOWNSHIP CT
STEPHENS CITY, VA 22655-2962
Phone number:
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