Individual
SCOTT EDWARD ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2606 AVENUE L, FORT MADISON, IA 52627-3839
(319) 372-9396
(319) 372-9610
Mailing address
2606 AVENUE L, FORT MADISON, IA 52627-3839
(319) 372-9396
(319) 372-9610
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18663
IA
Other
Enumeration date
10/02/2013
Last updated
10/02/2013
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