MRS. Kermalene Marie Ellsworth, PTA

NPI #1306107065 in Mchenry, Illinois

Provider Information

NPI Number
1306107065
Entity Type
Individual
Name
MRS. Kermalene Marie Ellsworth, PTA
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Physical Therapy Assistant
Credential
PTA
Enumeration Date
May 30, 2012
Last Updated
May 30, 2012

Practice Location

Address
5006 MEMORY TRL
ZIP Code
60051-7778
Phone
(847) 497-3264

Specialties & Taxonomy Codes

Specialty
Physical Therapy Assistant

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