Individual
JOSEPH EDWARD ELLWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
201 E LAUREL BLVD, POTTSVILLE, PA 17901-2534
(570) 628-4444
(570) 628-3088
Mailing address
860 FIRST AVE STE 1B, KING OF PRUSSIA, PA 19406-4033
(610) 265-0765
(610) 265-6824
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG002764
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102838030
—
PA
Enumeration date
06/14/2013
Last updated
07/05/2019
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