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Individual

DR. MICK ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
15 SULLIVAN DR APT B, ELMA, NY 14059-9510
(716) 239-7935
Mailing address
15 SULLIVAN DR APT B, ELMA, NY 14059-9510
(716) 239-7935

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X012390-1
NY

Other

Enumeration date
06/19/2014
Last updated
06/19/2014
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