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1003069147
MARK BRYAN ELLIS
LITTLE ROCK, AR
NPI
1003069147
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: AR otr567)
Enumeration Date
2008-11-03
Last Update Date
2008-11-03
Business Address
Mr. MARK BRYAN ELLIS otr/l
9601 INTERSTATE 630 EXIT 7
LITTLE ROCK, AR 72205-7202
Phone number: 501-202-7598
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Mailing Address
Mr. MARK BRYAN ELLIS otr/l
250 LORENE ST
AUSTIN, AR 72007-9137
Phone number: 501-605-8113
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