Provider Demographics
NPI:1558517458
Name:BRIGGS, ELLEN V (LMT)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:V
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 PLACIDA RD STE 115
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34224-5500
Mailing Address - Country:US
Mailing Address - Phone:941-223-4712
Mailing Address - Fax:
Practice Address - Street 1:2800 PLACIDA RD STE 115
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34224-5500
Practice Address - Country:US
Practice Address - Phone:941-223-4712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA54106172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist