Individual
DR. CARLY ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1824 VT 11, CHESTER, VT 05143-8621
(610) 906-5514
Mailing address
1824 VT 11, CHESTER, VT 05143-8621
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
134060
VT
Other
Enumeration date
06/21/2011
Last updated
12/04/2024
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