STACY BRIAN ELLISON

LOUISVILLE, KY
NPI1093843484
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: KY  5989)
Enumeration Date2007-02-28
Last Update Date2007-07-08
Business Address
Dr. STACY BRIAN ELLISON D.M.D.
2831 S HURSTBOURNE PKWY
LOUISVILLE, KY 40220-4112
Phone number: 502-491-0330
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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