Individual
LEONARD ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
26 N ELM ST, WATERBURY, CT 06702-1512
(203) 574-9000
Mailing address
141 E MAIN ST, WATERBURY, CT 06702-2310
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/14/2023
Last updated
12/14/2023
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