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Individual
MR. SCOTT MATTEW ELLINGER
Active
Individual
MR. SCOTT MATTEW ELLINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.142328-M-IV
OH
Other
Enumeration date
02/22/2012
Last updated
02/22/2012
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