Individual
SUZANNE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
114 SOUTH ST, QUINCY, OH 43343
(937) 538-7619
Mailing address
114 SOUTH ST, QUINCY, OH 43343
(937) 538-7619
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
0172435
OH
Other
Enumeration date
08/28/2016
Last updated
08/28/2016
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