Individual
MR. MARK J ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1101 JEFFERSON BLVD, HAGERSTOWN, MD 21742-5037
(301) 714-0200
(301) 739-8533
Mailing address
1101 JEFFERSON BLVD, HAGERSTOWN, MD 21742-5037
(301) 714-0200
(301) 739-8533
Taxonomy
Speciality
Code
Description
License number
State
2278G1100X
General Care Certified Respiratory Therapist
Primary
YM005079L
MD
Other
Enumeration date
12/22/2006
Last updated
07/08/2007
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