CHASTON J ELLIS

SALT LAKE CITY, UT
NPI1891373312
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: UT  12994417-1204)
Enumeration Date2021-03-29
Last Update Date2022-08-22
Business Address
CHASTON J ELLIS DO
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108-1222
Phone number: 801-581-7951
Mailing Address
CHASTON J ELLIS DO
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108-1222
Phone number: 801-581-7951
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