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1235607904
DALTON J ELLIS
OMAHA, NE
NPI
1235607904
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
Enumeration Date
2018-11-11
Last Update Date
2018-11-11
Business Address
DALTON J ELLIS
6111 S 136TH CIR
OMAHA, NE 68137-4111
Phone number: 402-980-1970
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Mailing Address
DALTON J ELLIS
6111 S 136TH CIR
OMAHA, NE 68137-4111
Phone number: 402-980-1970
Copy
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