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1124311162
ANTHONY JEROME ELLIS
UPLAND, CA
NPI
1124311162
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1744P3200X Specialist Prosthetics Case Management
Enumeration Date
2011-05-24
Last Update Date
2011-05-24
Business Address
MR. ANTHONY JEROME ELLIS C.P.
923 W FOOTHILL BLVD
UPLAND, CA 91786-3729
Phone number: 909-982-3434
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Mailing Address
MR. ANTHONY JEROME ELLIS C.P.
923 W FOOTHILL BLVD
UPLAND, CA 91786-3729
Phone number: 909-982-3434
Copy
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