Organization
JOHN E ELLIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN E. ELLIS O.D. (OWNER)
(724) 628-1370
Entity
Organization
Contact information
Practice address
619 E CRAWFORD AVE, CONNELLSVILLE, PA 15425-2102
(724) 628-1370
(724) 628-7314
Mailing address
619 E CRAWFORD AVE, CONNELLSVILLE, PA 15425-2102
(724) 628-1370
(724) 628-7314
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
OEG001091
PA
Other
Enumeration date
02/05/2008
Last updated
10/04/2012
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