Individual
DR. BRADLEY ELLINGSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
800 CLARK ST, CHARLES CITY, IA 50616-2218
(641) 228-1732
Mailing address
800 CLARK ST, CHARLES CITY, IA 50616-2218
(641) 228-1732
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002585
IA
Other
Enumeration date
05/30/2013
Last updated
09/12/2015
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