Individual
STEPHEN THOMAS ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 HOLLY PARK CT APT 6308, HOLLY SPRINGS, GA 30115-0226
(770) 380-2334
Mailing address
100 HOLLY PARK CT APT 6308, HOLLY SPRINGS, GA 30115-0226
(770) 380-2334
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/02/2024
Last updated
12/02/2024
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