Individual
LAURA ELLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19 E 42ND ST, COVINGTON, KY 41015-1712
(859) 786-7561
Mailing address
19 E 42ND ST, COVINGTON, KY 41015-1712
(859) 786-7561
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0330809
—
OH
Enumeration date
11/14/2020
Last updated
11/14/2020
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