Loni Ellis

NPI #1780818252 in Meridian, Idaho

Provider Information

NPI Number
1780818252
Entity Type
Individual
Name
Loni Ellis
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Specialist
Enumeration Date
May 12, 2009
Last Updated
May 12, 2009

Practice Location

Address
2524 N STOKESBERRY PL
State
Idaho
ZIP Code
83646-1144
Phone
(208) 373-7733

Specialties & Taxonomy Codes

Specialty
Specialist

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