Individual
MS. DEMETRIA ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
710 EVANS ST, EMPORIA, VA 23847-1358
(434) 532-9303
Mailing address
710 EVANS ST, EMPORIA, VA 23847-1358
(434) 532-9303
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
VA
Other
Enumeration date
06/24/2019
Last updated
06/24/2019
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