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Individual

JILL MARIE ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
4967 CROOKS RD STE 130, TROY, MI 48098-5812
(248) 952-1601
(248) 952-0192
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003809
MI

Other

Enumeration date
02/17/2006
Last updated
11/15/2013
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