Individual
ELIZABETH ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4390 BELLE OAKS DR, SUITE 120, NORTH CHARLESTON, SC 29405-8559
(866) 571-2700
Mailing address
503 QUAIL RUN DR, WARNER ROBINS, GA 31088-3038
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
3360
SC
Other
Enumeration date
02/20/2008
Last updated
02/20/2008
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