Individual
DR. JOHN ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5421 S 1900 W, ROY, UT 84067-2908
(801) 825-9703
Mailing address
5421 S 1900 W, ROY, UT 84067-2908
(801) 825-9703
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6617396-9934
UT
Other
Enumeration date
03/04/2008
Last updated
11/12/2018
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