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Individual

MR. DAVID MICHAEL ELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CPO

Contact information

Practice address
510 22ND AVE E, SUITE# 801 ADVANCE ORTHOTICS & PROSTHETICS,, ALEXANDRIA, MN 56308-4653
(320) 762-2210
(320) 762-2753
Mailing address
510 22ND AVE E, SUITE# 801 ADVANCE ORTHOTICS & PROSTHETICS,, ALEXANDRIA, MN 56308-4653
(320) 762-2210
(320) 762-2753

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
224P00000X
Prosthetist
Primary

Other

Enumeration date
09/19/2007
Last updated
10/30/2007
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