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1497189203
GARY D ELLIS
DAYTON, OH
NPI
1497189203
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2013-08-28
Last Update Date
2013-08-28
Business Address
-- GARY D ELLIS
4881 SUGAR MAPLE DR 88MDG/MDOS/SGOW WRIGHT PATTERSON AFB
DAYTON, OH 45433-5529
Phone number: 937-257-6876
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Mailing Address
-- GARY D ELLIS
2489 EDGEWATER DR UNIT 2
BEAVERCREEK, OH 45431-5644
Phone number: 740-274-1826
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