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Individual

MATTHEW P ELLERBROCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
120 N MAIN ST, SUITE A, BLUFFTON, OH 45817-0205
(419) 358-2222
(419) 932-6950
Mailing address
120 N MAIN ST, SUITE A, BLUFFTON, OH 45817-1201
(419) 358-2222
(419) 932-6950

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2927
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2149160
OH
Enumeration date
11/20/2006
Last updated
08/09/2016
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