| Ursula J. Edwards Ellerby | |
|
500 Lanier Ave W Ste 411 Fayetteville GA 30214-7638 | |
| (404) 765-0798 | |
| Not Available |
| Full Name | Ursula J. Edwards Ellerby |
|---|---|
| Speciality | Clinic/center |
| Location | 500 Lanier Ave W Ste 411, Fayetteville, Georgia |
| Authorized Official Name and Position | Ursula Jacinta Edwards Ellerby (CEO/NEUROMUSCULAR THERAPIST) |
| Authorized Official Contact | 4047650798 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ursula J. Edwards Ellerby 8299 Dewayne Ln Jonesboro GA 30236-3710 Ph: (404) 765-0798 | Ursula J. Edwards Ellerby 500 Lanier Ave W Ste 411 Fayetteville GA 30214-7638 Ph: (404) 765-0798 |
| NPI Number | 1376728154 |
|---|---|
| Provider Enumeration Date | 12/30/2007 |
| Last Update Date | 09/24/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376728154 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | MT003516 (Georgia) | Primary |
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