Individual
TYLER ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.A.C
Contact information
Practice address
175 BOSTON POST RD STE 1, WATERFORD, CT 06385-2815
(860) 271-7354
Mailing address
122 FOSTER ST, NEW HAVEN, CT 06511-2655
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
846112
CT
Other
Enumeration date
11/12/2021
Last updated
11/12/2021
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