ELLISS DESHEROW

LAWTON, OK
NPI1073301206
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2025-04-28
Last Update Date2025-04-28
Business Address
ELLISS DESHEROW DO
3401 W GORE BLVD
LAWTON, OK 73505-6332
Phone number: 580-355-8620
Mailing Address
ELLISS DESHEROW DO
38W155 HENRICKSEN RD
ST CHARLES, IL 60175-5471
Phone number: 224-678-4061