Individual
PATRICIA A ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21494 AVON LN, SOUTHFIELD, MI 48075-7104
(616) 264-8156
Mailing address
21494 AVON LN, SOUTHFIELD, MI 48075-7104
(616) 264-8156
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
07/11/2024
Last updated
07/11/2024
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