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1922313238
STEPHANIE M ELLIS
PEORIA, IL
NPI
1922313238
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2010-08-11
Last Update Date
2010-08-11
Business Address
Mrs. STEPHANIE M ELLIS PA
4909 N GLEN PARK PLACE RD
PEORIA, IL 61614-4676
Phone number: 309-674-7546
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Mailing Address
Mrs. STEPHANIE M ELLIS PA
4909 N GLEN PARK PLACE RD
PEORIA, IL 61614-4676
Phone number: 309-674-7546
Copy
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