Individual
BENJAMIN KWEKU ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
901 CORRECTION WAY, JARRATT, VA 23870-9998
(434) 535-7098
Mailing address
6206 ARBOR BANKS TER, CHESTER, VA 23831-7752
(804) 796-5018
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001469
VA
Other
Enumeration date
05/16/2007
Last updated
07/08/2007
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