Individual
BRIAN ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1802 6TH AVE S, BIRMINGHAM, AL 35233-1932
(205) 934-9999
Mailing address
1802 6TH AVE S, BIRMINGHAM, AL 35233-1932
(205) 934-9999
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1-169034
AL
Other
Enumeration date
04/23/2021
Last updated
04/23/2021
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