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Individual

DR. WENDELL L. ELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1475 SIMPSON RD W, SUITE 1, LENOIR CITY, TN 37771-6685
(865) 988-9088
(865) 988-9299
Mailing address
1475 SIMPSON RD W, SUITE 1, LENOIR CITY, TN 37771-6685
(865) 988-9088
(865) 988-9299

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
434
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4078449
BLUE CROSS BLUE SHIELD
TN
01
610495500
USPS INJURY COMP.
TN
01
702004131
CARITEN
TN
01
9416305
CIGNA
TN
Enumeration date
05/04/2006
Last updated
01/04/2011
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