Individual
CODY J ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10072 WIRT PLZ APT 2, OMAHA, NE 68134-5485
(402) 686-6776
Mailing address
10072 WIRT PLZ APT 2, OMAHA, NE 68134-5485
(402) 686-6776
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
04/22/2025
Last updated
04/22/2025
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