GRANT WILLAM ELLIS

PEDRO, OH
NPI1740062819
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2023-10-13
Last Update Date2023-10-13
Business Address
Mr. GRANT WILLAM ELLIS
115 PRIVATE ROAD 977
PEDRO, OH 45659-8608
Phone number: 740-534-1386
Mailing Address
Mr. GRANT WILLAM ELLIS
115 PRIVATE ROAD 977
PEDRO, OH 45659-8608
Phone number: 740-534-1386