Individual
ELIZABETH F ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2061 BEVERLY RD, GAINESVILLE, GA 30501-2034
(770) 532-4444
(678) 971-5172
Mailing address
2061 BEVERLY RD, GAINESVILLE, GA 30501-2034
(770) 532-4444
(678) 971-5172
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002868
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003169594A
—
GA
Enumeration date
06/16/2015
Last updated
08/03/2016
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