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1740062819
GRANT WILLAM ELLIS
PEDRO, OH
NPI
1740062819
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2023-10-13
Last Update Date
2023-10-13
Business Address
Mr. GRANT WILLAM ELLIS
115 PRIVATE ROAD 977
PEDRO, OH 45659-8608
Phone number: 740-534-1386
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Mailing Address
Mr. GRANT WILLAM ELLIS
115 PRIVATE ROAD 977
PEDRO, OH 45659-8608
Phone number: 740-534-1386
Copy
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