Individual
JOSEPH ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
115 S MAIN ST, MIAMI, OK 74354-7024
(918) 544-6663
Mailing address
917 I ST NW, MIAMI, OK 74354-4239
(918) 373-0318
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
03/18/2025
Last updated
03/18/2025
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