Individual
ELLEN BRISTOL II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 HICKORY RD, PLYMOUTH MEETING, PA 19462-1047
(800) 879-4471
Mailing address
3905 TWIN CIRCLE WAY, BALTIMORE, MD 21227-3511
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP36514
MD
Other
Enumeration date
02/25/2009
Last updated
02/25/2009
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