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1093843484
STACY BRIAN ELLISON
LOUISVILLE, KY
NPI
1093843484
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist General Practice
(Licence: KY 5989)
Enumeration Date
2007-02-28
Last Update Date
2007-07-08
Business Address
DR. STACY BRIAN ELLISON D.M.D.
2831 S HURSTBOURNE PKWY
LOUISVILLE, KY 40220-4112
Phone number: 502-491-0330
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Mailing Address
DR. STACY BRIAN ELLISON D.M.D.
2831 S HURSTBOURNE PKWY
LOUISVILLE, KY 40220-4112
Phone number: 502-491-0330
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