Individual
MR. JOSHUA CHARLES ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
A.T.C., C.S.C.S.
Contact information
Practice address
321 KANSAS CITY ST, RAPID CITY, SD 57701-2820
(605) 394-4860
Mailing address
509 CITY SPRINGS RD, APT 12, RAPID CITY, SD 57702-0155
(605) 737-0464
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0107
SD
Other
Enumeration date
01/17/2007
Last updated
07/08/2007
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