Individual
DR. JEREMY ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
4901 FRIEDMAN LN, FORT WORTH, TX 76244-6121
(682) 302-4476
Mailing address
4901 FRIEDMAN LN, FORT WORTH, TX 76244-6121
Taxonomy
Speciality
Code
Description
License number
State
111NI0900X
Internist Chiropractor
Primary
11376
TX
Other
Enumeration date
07/07/2015
Last updated
07/07/2015
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