Individual
MARQUIS R ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR-L
Contact information
Practice address
5406 MERLE HAY RD, JOHNSTON, IA 50131-1209
(515) 727-8750
(515) 727-8757
Mailing address
4229 SE 7TH ST, DES MOINES, IA 50315-4311
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
000905
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29818
WELLMARK BCBS
IA
Enumeration date
05/30/2007
Last updated
07/08/2007
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