NOLAN ANDREW ELLIS

SAN DIEGO, CA
NPI1174019046
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2018-07-03
Last Update Date2018-07-03
Business Address
NOLAN ANDREW ELLIS DIVE IDC
3156 SALMON ST
SAN DIEGO, CA 92124-3616
Phone number: 859-802-9800
Mailing Address
NOLAN ANDREW ELLIS DIVE IDC
3156 SALMON ST
SAN DIEGO, CA 92124-3616
Phone number: