Individual
PATRICIA ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
25 COURTHOUSE DR NE, BOLIVIA, NC 28422
(888) 428-4429
(910) 253-2379
Mailing address
25 COURTHOUSE DR NE PO BOX 9, BOLIVIA, NC 28422
(888) 428-4429
(910) 253-2379
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
L001598
NC
133V00000X
Registered Dietitian
Primary
651244
NC
Other
Enumeration date
07/09/2008
Last updated
07/09/2008
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