Individual
COLTER ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
3006 VININGS FERRY DR SE, ATLANTA, GA 30339-4300
(828) 460-7789
Mailing address
3006 VININGS FERRY DR SE, ATLANTA, GA 30339-4300
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD006552
GA
Other
Enumeration date
11/07/2023
Last updated
11/07/2023
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