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1285197673
JASON TED ELLIS
SPENCER, IA
NPI
1285197673
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: IA 18437)
Enumeration Date
2019-04-11
Last Update Date
2019-04-11
Business Address
JASON TED ELLIS Rph
500 11TH ST SW
SPENCER, IA 51301-5826
Phone number: 712-262-5011
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Mailing Address
JASON TED ELLIS Rph
1503 W 13TH ST
SPENCER, IA 51301-2925
Phone number: 712-260-6120
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