Individual
PAMELA NICHELLE ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MLT
Contact information
Practice address
619 19TH ST SOUTH, BIRMINGHAM, AL 35233
(205) 934-6390
Mailing address
620 CHERRY ST NW, DECATUR, AL 35601-1273
(256) 565-2640
Taxonomy
Speciality
Code
Description
License number
State
246RM2200X
Medical Laboratory Technician
Primary
—
—
Other
Enumeration date
07/02/2007
Last updated
07/08/2007
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