Individual
ANTHONY ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7271 ENGLE RD, MIDDLEBURG HEIGHTS, OH 44130-8488
(614) 339-1649
Mailing address
7271 ENGLE RD, MIDDLEBURG HEIGHTS, OH 44130-8488
(614) 339-1649
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2910854
—
OH
Enumeration date
07/01/2021
Last updated
07/01/2021
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