Charlie Laverne Ellis

NPI #1023827516 in Leesburg, Georgia

Provider Information

NPI Number
1023827516
Entity Type
Individual
Name
Charlie Laverne Ellis
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Occupational Therapy Assistant
Enumeration Date
Dec 30, 2024
Last Updated
Dec 30, 2024

Practice Location

Address
119 JEFFERSON CT
State
Georgia
ZIP Code
31763-4920
Phone
(229) 869-3919

Specialties & Taxonomy Codes

Specialty
Occupational Therapy Assistant

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