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1780009027
DEMETRIUS J ELLIS
TULSA, OK
NPI
1780009027
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2014-02-24
Last Update Date
2014-02-24
Business Address
-- DEMETRIUS J ELLIS
2001 S GARNETT RD STE G
TULSA, OK 74128-1838
Phone number: 918-878-7877
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Mailing Address
-- DEMETRIUS J ELLIS
5201 S WESTERN AVE
OKLAHOMA CITY, OK 73109-4526
Phone number: 405-632-0870
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