Individual
KENPRIL KENISE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
194 AINSDALE DR, RICHMOND HILL, GA 31324-7821
(607) 621-5676
Mailing address
12008 MIDDLEGROUND RD APT R7, SAVANNAH, GA 31419-3637
(478) 335-4813
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Enumeration date
04/16/2025
Last updated
04/16/2025
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