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1306358270
JACOB BRANNON ELLIS
MADISON, AL
NPI
1306358270
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: AL 4316)
Enumeration Date
2017-10-31
Last Update Date
2017-10-31
Business Address
JACOB BRANNON ELLIS
97 HUGHES RD STE H
MADISON, AL 35758-3401
Phone number: 256-883-7338
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Mailing Address
JACOB BRANNON ELLIS
97 HUGHES RD STE H
MADISON, AL 35758-3401
Phone number: 256-883-7338
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