Individual
AUSTIN SAMUEL ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1901 E 1ST ST, NEWTON, KS 67114-5010
(316) 284-6400
(316) 284-6490
Mailing address
PO BOX 467, NEWTON, KS 67114-0467
(316) 284-6400
(316) 284-6490
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/31/2019
Last updated
01/31/2019
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