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Individual

IBRAHIM ELLITHY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPO

Contact information

Practice address
10615 W THUNDERBIRD BLVD STE D165, SUN CITY, AZ 85351-3033
(623) 977-2221
Mailing address
17431 N 83RD DR, PEORIA, AZ 85382-8083
(623) 302-0919

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
224P00000X
Prosthetist
Primary

Other

Enumeration date
10/29/2020
Last updated
10/29/2020
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