MR. Grant Willam Ellis

NPI #1740062819 in Pedro, Ohio

Provider Information

NPI Number: 1740062819
Entity Type: Individual
Name: MR. Grant Willam Ellis
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Case Manager/Care Coordinator
Enumeration Date: Oct 13, 2023
Last Updated: Oct 13, 2023

Practice Location

Address: 115 PRIVATE ROAD 977
City: Pedro
State: Ohio
ZIP Code: 45659-8608
Phone: (740) 534-1386

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Manager/Care Coordinator	171M00000X	Primary

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