Individual
LACRESHA ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4603 BRICKWOOD MEADOW DR, NORTH DINWIDDIE, VA 23803-8875
(804) 895-8450
Mailing address
4603 BRICKWOOD MEADOW DR, NORTH DINWIDDIE, VA 23803-8875
(804) 895-8450
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
06/01/2021
Last updated
11/17/2023
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