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MICHAEL T ELLIS DC

>> Chiropractor >> Chiropractic Providers

Registrant NPI Number: 1760416127

Individual Registrant:
 MICHAEL T ELLIS DC
Gender: M
Sole Proprietor

Location and contact information for practice:
4664 MAIN ST.  GRANT, AL 35747-8308 US
Tel: 256-728-2044  Fax: 256-728-2044

Contact information for business:
4664 MAIN STREET  GRANT, AL 35747-8308 US
Tel: 256-728-2044  Fax: 256-728-2044

Registration Information:
NPI: 1760416127
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y111N00000XChiropractic Providers
Chiropractor
AL1439

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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