Individual
MANDIE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DAOM
Contact information
Practice address
1991 VICTORY HWY, GLENDALE, RI 02826-1670
(401) 710-4207
Mailing address
153 WOODSTOCK AVE, PUTNAM, CT 06260-1429
(978) 798-8804
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
DAOM00088
RI
Other
Enumeration date
03/10/2022
Last updated
03/10/2022
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