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1194139014
JEFFERY ELLIS
LOUISVILLE, KY
NPI
1194139014
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2014-06-18
Last Update Date
2014-06-18
Business Address
Mr. JEFFERY ELLIS
600 S PRESTON ST
LOUISVILLE, KY 40202-1716
Phone number: 502-583-3951
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Mailing Address
Mr. JEFFERY ELLIS
211 WHIPPOORWILL DR
LOUISVILLE, KY 40222-4837
Phone number: 502-403-5933
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