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1265670749
ELLISIV LIEN
TYLER, TX
NPI
1265670749
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
208100000X Physical Medicine & Rehabilitation
(Licence: TX N1735)
Enumeration Date
2009-01-22
Last Update Date
2019-01-31
Business Address
ELLISIV LIEN MD
2737 S BROADWAY AVE
TYLER, TX 75701-5413
Phone number: 903-592-6000
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Mailing Address
ELLISIV LIEN MD
PO BOX 6605
TYLER, TX 75711-6605
Phone number: 903-592-6000
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