Individual
BRENTON J ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3911 AVENUE B, SUITE 2250, SCOTTSBLUFF, NE 69361-4617
(306) 630-1950
Mailing address
3911 AVENUE B, SUITE 2250, SCOTTSBLUFF, NE 69361-4617
(308) 630-1950
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
26731
NE
Other
Enumeration date
06/02/2008
Last updated
06/27/2012
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