Individual
MRS. CHERI G ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R. D. H.
Contact information
Practice address
7052 PATRICK RD, CITRONELLE, AL 36522-5145
(251) 610-2455
Mailing address
7052 PATRICK RD, CITRONELLE, AL 36522
(251) 610-2455
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
5121
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MAY2762
NPI
AL
Enumeration date
03/25/2009
Last updated
03/25/2009
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