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Individual

JUSTIN CRAIG ELLERBROEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3741 PHEASANT LN, WATERLOO, IA 50701-5215
(319) 234-6000
(319) 234-6001
Mailing address
PO BOX 2400, WATERLOO, IA 50704-2400
(319) 234-6000
(319) 234-6001

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
38816
IA
207ND0101X
MOHS-Micrographic Surgery Physician
38816
IA

Other

Enumeration date
06/22/2007
Last updated
06/13/2024
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