Individual
CODY W. ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
16039 LAVENHAM RD, HUNTERSVILLE, NC 28078-5660
(803) 517-6319
Mailing address
16039 LAVENHAM RD, HUNTERSVILLE, NC 28078-5660
(803) 517-6319
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86299004
SC
Other
Enumeration date
04/12/2025
Last updated
04/12/2025
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