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Individual

JANET RAYE ELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CST, LFA

Contact information

Practice address
4601 50TH ST, SUITE 106, LUBBOCK, TX 79414-3513
(806) 785-2093
Mailing address
311 E 19TH ST, WOLFFORTH, TX 79382-2809

Taxonomy

Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
SA00066
TX

Other

Enumeration date
02/21/2007
Last updated
07/08/2007
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