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1770877896
JEREMY WAYNE ELLISON
JONESBORO, AR
NPI
1770877896
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2011-06-06
Last Update Date
2011-06-07
Business Address
-- JEREMY WAYNE ELLISON MHPP
1217 STONE ST
JONESBORO, AR 72401-4520
Phone number: 870-972-1268
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Mailing Address
-- JEREMY WAYNE ELLISON MHPP
1217 STONE ST
JONESBORO, AR 72401-4520
Phone number: 870-972-1268
Copy
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