Individual
MS. JULIA FAYE ELLESTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
527 MEDICAL PARK DR, BRIDGEPORT, WV 26330-9008
(681) 342-3620
Mailing address
412 CONFEDERATE CIR, LEXINGTON, VA 24450-1716
(540) 460-1851
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/29/2024
Last updated
04/29/2024
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