Individual
ROGER D. ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1508 SCOTTSVILLE RD, LAFAYETTE, TN 37083-2237
(501) 749-6205
Mailing address
1508 SCOTTSVILLE RD, LAFAYETTE, TN 37083-2237
(501) 749-6205
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
1255
AR
111NX0800X
Orthopedic Chiropractor
Primary
1333
TN
Other
Enumeration date
02/02/2009
Last updated
02/02/2009
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