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1528414984
JOHN ELLISON
LEWISBURG, WV
NPI
1528414984
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: WV ED1234)
Enumeration Date
2016-05-04
Last Update Date
2016-05-04
Business Address
JOHN ELLISON
400 N JEFFERSON ST
LEWISBURG, WV 24901-1177
Phone number: 304-645-3220
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Mailing Address
JOHN ELLISON
400 N JEFFERSON ST
LEWISBURG, WV 24901-1177
Phone number: 304-645-3220
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