Individual
DR. LORA ELIZABETH ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
76 REMICK BLVD, SPRINGBORO, OH 45066-9168
(937) 885-4475
(937) 885-3670
Mailing address
76 REMICK BLVD, SPRINGBORO, OH 45066-9168
(937) 885-4475
(937) 885-3670
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35086223
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2592690
—
OH
Enumeration date
10/03/2006
Last updated
07/08/2007
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