Individual
JOSHUA ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
550 N HILLSIDE ST, WICHITA, KS 67214-4910
(316) 962-2668
Mailing address
200 E WINDING LANE CIR, DERBY, KS 67037-8818
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01822
KS
Other
Enumeration date
09/09/2015
Last updated
09/09/2015
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