Individual
MR. RONALD MICHAAEL ELLSWORTH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
75 N GARDEN AVE, SIERRA VISTA, AZ 85635-3805
(520) 610-3106
Mailing address
75 N GARDEN AVE, SIERRA VISTA, AZ 85635-3805
(520) 610-3106
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
840483
TX
Other
Enumeration date
02/13/2015
Last updated
02/13/2015
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