Individual
MR. BRANDON ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
453 EATONVILLE RD, HATTIESBURG, MS 39401-9754
(601) 434-2229
Mailing address
453 EATONVILLE RD, HATTIESBURG, MS 39401-9754
(601) 434-2229
Taxonomy
Speciality
Code
Description
License number
State
226300000X
Kinesiotherapist
Primary
—
—
Other
Enumeration date
04/15/2019
Last updated
04/15/2019
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