Individual
ALEXANDER ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2316 WALKER BLD, AUBURN UNIVERSITY, AL 36849-0001
(321) 848-4237
Mailing address
228 N DEBARDELEBEN ST, AUBURN, AL 36830-4926
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
S12437
AL
Other
Enumeration date
01/17/2019
Last updated
01/17/2019
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