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Individual

JAMES RUSSELL ELLISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
3411 S NOLAND RD, INDEPENDENCE, MO 64055-1319
(816) 252-0094
Mailing address
10024 W 118TH TER APT 8, OVERLAND PARK, KS 66210-3193

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
1-106867
KS
183500000X
Pharmacist
Primary
18552-40
WI
183500000X
Pharmacist
2019014830
MO

Other

Enumeration date
02/13/2019
Last updated
05/06/2022
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