G Richard Ellis, PA-C

NPI #1184840597 in Bountiful, Utah

Provider Information

NPI Number: 1184840597
Entity Type: Individual
Name: G Richard Ellis, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Apr 17, 2007
Last Updated: Apr 4, 2016

Practice Location

Address: 520 MEDICAL DR
Address 2: SUITE #310
City: Bountiful
State: Utah
ZIP Code: 84010-4968
Phone: (801) 397-3000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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