Individual
MICHEL F ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1252 WESTPHAL AVE, COLUMBUS, OH 43227-2041
(614) 806-0633
Mailing address
1252 WESTPHAL AVE, COLUMBUS, OH 43227-2041
(614) 806-0633
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
4542810
OH
Other
Enumeration date
05/11/2022
Last updated
05/11/2022
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