Individual
DEAN ROYALE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11401 NALL AVE, STE 200, LEAWOOD, KS 66211-1674
(913) 685-2983
Mailing address
7840 MONTGOMERY RD, CINCINNATI, OH 45236-4301
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
428942
KS
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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