Individual
BAILEY R ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
450 LAUREL ST STE A, DES MOINES, IA 50314-3045
(515) 247-8400
Mailing address
27070 RACCOON RDG, ADEL, IA 50003-8599
(515) 556-7244
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2022
Last updated
11/09/2023
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