Individual
DR. SHARON KELLY ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
5370 STONE MOUNTAIN HWY, SUITE 700, STONE MOUNTAIN, GA 30087-3581
(770) 879-1961
(770) 879-9872
Mailing address
4173 PROVIDENCE LN, TUCKER, GA 30084-2629
(678) 937-1622
(678) 937-1627
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1283
GA
Other
Enumeration date
11/28/2006
Last updated
07/08/2007
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