Individual
SHAWN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3533 SOUTHERN BLVD, STE 5650, KETTERING, OH 45429-1264
(937) 294-3611
(937) 294-9010
Mailing address
3533 SOUTHERN BLVD, STE 5650, KETTERING, OH 45429-1264
(937) 294-3611
(937) 294-9010
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
060010
OH
Other
Enumeration date
02/06/2009
Last updated
02/06/2009
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