DALTON J ELLIS

OMAHA, NE
NPI1235607904
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date2018-11-11
Last Update Date2018-11-11
Business Address
DALTON J ELLIS
6111 S 136TH CIR
OMAHA, NE 68137-4111
Phone number: 402-980-1970
Mailing Address
DALTON J ELLIS
6111 S 136TH CIR
OMAHA, NE 68137-4111
Phone number: 402-980-1970
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