Individual
JORDAN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 E MEDICAL CENTER DRIVE, UH B1D530, SPC 5030, ANN ARBOR, MI 48109-5030
(734) 615-4924
Mailing address
1500 E MEDICAL CENTER DRIVE, UH B1D530, SPC 5030, ANN ARBOR, MI 48109-5030
(734) 615-4924
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
4351047774
MI
Other
Enumeration date
06/02/2021
Last updated
06/02/2021
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