Individual
CLINTON ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2600 N BROADWAY ST, PITTSBURG, KS 66762-2623
(620) 232-3066
Mailing address
2600 N BROADWAY ST, PITTSBURG, KS 66762-2623
(620) 232-3066
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-17010
KS
Other
Enumeration date
02/07/2017
Last updated
02/07/2017
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