Mark a Ellison, Ltd

NPI #1013967116 in Bethalto, Illinois

Provider Information

NPI Number: 1013967116
Entity Type: Organization
Organization Name: Mark a Ellison, Ltd
Primary Specialty: Optometrist
Enumeration Date: May 11, 2006
Last Updated: Aug 21, 2008

Practice Location

Address: 422 W BETHALTO DR
City: Bethalto
State: Illinois
ZIP Code: 62010-1700
Phone: (618) 377-5221

Authorized Official

Name: DR. MARK A. ELLISON, O.D.
Title: PRESIDENT
Phone: (618) 635-2424

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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