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Individual
JOHN P ELLIS
Active
Individual
JOHN P ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RECOVERY ASSISTANT
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
AR
Other
Enumeration date
05/24/2011
Last updated
05/24/2011
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