# MEDSPA WOMAN'S HELATHCARE, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588785653
- **Authorized official:** DR. JULIUS RODNEY ELLIS M.D. (DOCTOROWNER)
- **Authorized official phone:** (219) 362-4690

## Contact information

- **Practice address:** 901 LINCOLNWAY, SUITE 306, LA PORTE, IN 46350-3430
- **Practice address phone:** (219) 362-4690
- **Practice address fax:** (219) 362-4692
- **Mailing address:** 901 LINCOLNWAY, SUITE 306, LA PORTE, IN 46350-3430
- **Mailing address phone:** (219) 362-4690
- **Mailing address fax:** (219) 362-4692

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 01052711A | IN | Yes |

## Other

- **Enumeration date:** 04/03/2007
- **Last updated:** 08/22/2020