Ellie King

NPI #1295438257 in Montgomery, Illinois

Provider Information

NPI Number: 1295438257
Entity Type: Individual
Name: Ellie King
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Mar 27, 2023
Last Updated: Mar 27, 2023

Practice Location

Address: 1932 LAKESIDE DR
City: Montgomery
State: Illinois
ZIP Code: 60538-3041
Phone: (321) 527-8635

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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