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1295140887
DESTA ELLIS
VISALIA, CA
NPI
1295140887
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2014-06-23
Last Update Date
2014-06-23
Business Address
-- DESTA ELLIS M.D.
400 W MINERAL KING AVE
VISALIA, CA 93291-6237
Phone number: 559-624-6999
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Mailing Address
-- DESTA ELLIS M.D.
400 W MINERAL KING AVE
VISALIA, CA 93291-6237
Phone number: 559-624-6999
Copy
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