Individual
JOHN ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, NMT
Contact information
Practice address
77 3RD AVENUE WEST N, KALISPELL, MT 59901-4049
(407) 752-3105
Mailing address
PO BOX 130070, CORAM, MT 59913-0070
(406) 260-8826
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
6534
MT
Other
Enumeration date
04/12/2016
Last updated
04/12/2016
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