Ellen L. Ellsworth, Od INC

NPI #1568642890 in Mentor, Ohio

Provider Information

NPI Number
1568642890
Entity Type
Organization
Organization Name
Ellen L. Ellsworth, Od INC
Primary Specialty
Optometrist
Enumeration Date
Nov 3, 2007
Last Updated
Jul 2, 2008

Practice Location

Address
9930 JOHNNYCAKE RIDGE RD
Address 2
SUITE 4B
City
Mentor
State
Ohio
ZIP Code
44060-6752
Phone
(440) 352-8031

Authorized Official

Name
DR. ELLEN LILLE ELLSWORTH, O.D.
Title
PRESIDENT
Phone
(440) 352-8031

Specialties & Taxonomy Codes

Specialty
Optometrist

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