MR. Sue Ellen Nesslage, PTA

NPI #1588872238 in Sullivan, Missouri

Provider Information

NPI Number: 1588872238
Entity Type: Individual
Name: MR. Sue Ellen Nesslage, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: May 18, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 875 DUNSFORD DR
City: Sullivan
State: Missouri
ZIP Code: 63080-1238
Phone: (573) 468-3128

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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