Individual
JENNIFER ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
208 ORIOLE ST., HARRISONVILLE, MO 64701-0000
(816) 887-2010
Mailing address
208 ORIOLE ST., HARRISONVILLE, MO 64701-0000
(816) 887-2010
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
1174
MO
Other
Enumeration date
05/06/2014
Last updated
05/06/2014
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