Individual
MR. JOHN WESLEY ELLIS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CHAPLAIN
Contact information
Practice address
4801 E LINWOOD BLVD, KANSAS CITY, MO 64128-2226
(816) 861-4800
Mailing address
6215 E 109TH ST, KANSAS CITY, MO 64134-2543
(706) 840-2902
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
06/18/2013
Last updated
06/18/2013
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