Individual
TRACY ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9499 W CHARLESTON BLVD, STE 200, LAS VEGAS, NV 89117-7150
(702) 869-9983
Mailing address
9499 W CHARLESTON BLVD, STE 200, LAS VEGAS, NV 89117-7150
(702) 869-9983
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
153753
NV
Other
Enumeration date
01/06/2015
Last updated
01/06/2015
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