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1790505683
ELLIE JANE MAKOUL
PORTAGE, MI
NPI
1790505683
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601012711)
Enumeration Date
2024-10-15
Last Update Date
2024-10-15
Business Address
ELLIE JANE MAKOUL PA-C
3770 GLENKERRY CT
PORTAGE, MI 49024-0700
Phone number: 269-329-2887
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Mailing Address
ELLIE JANE MAKOUL PA-C
3770 GLENKERRY CT
PORTAGE, MI 49024-0700
Phone number:
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