Individual
JULIE MARIA ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4916 DAVIDSON RUN DR, HILLIARD, OH 43026-3826
(614) 499-5218
Mailing address
4916 DAVIDSON RUN DR, HILLIARD, OH 43026-3826
(614) 499-5218
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
OT4212
OH
Other
Enumeration date
02/09/2014
Last updated
02/09/2014
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