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1114701075
AUSTIN ELLIS
FARGO, ND
NPI
1114701075
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: ND 2041)
Enumeration Date
2023-08-22
Last Update Date
2023-08-22
Business Address
AUSTIN ELLIS OTR/L
1461 BROADWAY N
FARGO, ND 58102-2622
Phone number: 701-293-6037
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Mailing Address
AUSTIN ELLIS OTR/L
1461 BROADWAY N
FARGO, ND 58102-2622
Phone number:
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