Organization
ELLIS MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTY DAWN CUNNINGHAM (BUSINESS MANAGER)
(785) 520-5020
Entity
Organization
Contact information
Practice address
814 JEFFERSON ST, ELLIS, KS 67637-2215
(785) 520-5020
(785) 520-5025
Mailing address
PO BOX 174, ELLIS, KS 67637-0174
(785) 259-4261
(785) 520-5025
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/06/2018
Last updated
02/16/2019
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