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Individual
DR. JASON LEE ELLIS
Active
Individual
DR. JASON LEE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2301009298
MI
111N00000X
Chiropractor
Primary
4989
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3I335EL
BCBS
MN
01
—
716650
ACN
MN
01
—
CC1343A
CHIROCARE
MN
Enumeration date
02/28/2007
Last updated
10/13/2017
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