Individual
MR. CHRISTOPHER J ELLENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
201 S WILLIAM ST, SOUTH BEND, IN 46601-2515
(574) 234-2870
(574) 232-2872
Mailing address
PO BOX 11582, SOUTH BEND, IN 46634-0582
(574) 234-2870
(574) 232-2872
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/18/2011
Last updated
05/18/2011
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