Individual
DR. MATTHEW L ELLIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1700 CERRILLOS RD, SANTA FE, NM 87505-3554
(505) 946-9387
Mailing address
1700 CERRILLOS RD, SANTA FE, NM 87505-3554
(505) 946-9387
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6547
NM
Other
Enumeration date
10/02/2005
Last updated
07/08/2007
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