Individual
TREASE P ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3411 DIVISION DR, WEST PLAINS, MO 65775-5789
(417) 256-9152
Mailing address
3411 DIVISION DR, WEST PLAINS, MO 65775-5789
(417) 256-9152
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
06/30/2011
Last updated
06/30/2011
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