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1487225744
SHANNON ELLIS
MORGANTOWN, WV
NPI
1487225744
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2021-07-08
Last Update Date
2021-07-08
Business Address
SHANNON ELLIS
382 BROADWAY AVE
MORGANTOWN, WV 26505-0364
Phone number: 304-599-7743
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Mailing Address
SHANNON ELLIS
382 BROADWAY AVE
MORGANTOWN, WV 26505-0364
Phone number: 304-599-7743
Copy
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