| NPI | 1255820858 |
|---|---|
| Doing Business As | DR. WILFRED ELLIS BUILDING |
| Entity Type | Organization |
| Authorized Contact | JANIS L SUNDERHAUS CEO 419-221-3072 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2018-07-05 |