Individual
KATHRYN R ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
730 MAIN ST, 1A, MILLIS, MA 02054-1612
(508) 376-2515
(508) 376-9932
Mailing address
171 MAIN ST STE 203B, ASHLAND, MA 01721-1187
(508) 881-3029
(508) 881-1752
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
160327
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3204723
—
MA
Enumeration date
01/06/2006
Last updated
01/16/2024
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