MRS. Shannon M Ellis, PTA

NPI #1568867430 in Braselton, Georgia

Provider Information

NPI Number: 1568867430
Entity Type: Individual
Name: MRS. Shannon M Ellis, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Nov 4, 2014
Last Updated: Nov 4, 2014

Practice Location

Address: 5775 OLD WINDER HWY
City: Braselton
State: Georgia
ZIP Code: 30517-1603
Phone: (678) 866-4104

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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