Individual
CASEY COLDIRON ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
WOMACK 2817 ROCK MERRITT AVE, FORT BRAGG, NC 28310-0001
(910) 907-6000
Mailing address
WOMACK 2817 ROCK MERRITT AVE, FORT BRAGG, NC 28310-0001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-12477
NC
Other
Enumeration date
07/13/2022
Last updated
06/12/2025
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