Most Relevant Information
Provider Data
| NPI Number: | 1003449984 |
| Provider Name: | LILLIAN ELISE ELLISON |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | PT015118 |
Most Important Dates
| Enumeration Date: | 02/19/2020 |
| Last Updated: | 02/19/2020 |
Provider Practice Location
19189 OH STATE ROUTE 136
WINCHESTER
OH
45697
Practice Location Phone/Fax
| Phone: | 9376950839 |
| Fax: |
Provider Mailing Location
10133 FINCASTLE WINCHESTER RD
WINCHESTER
OH
456979495
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |