Ellis Timothy Charles

NPI #1871029314 in Sheridan, Wyoming

Provider Information

NPI Number
1871029314
Entity Type
Individual
Name
Ellis Timothy Charles
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Day Training, Developmentally Disabled Services
Enumeration Date
May 3, 2017
Last Updated
May 3, 2017

Practice Location

Address
511 GLADSTONE ST
Address 2
511 GLADSTONE STREET
State
Wyoming
ZIP Code
82801-4830
Phone
(307) 752-9082

Specialties & Taxonomy Codes

Specialty
Day Training, Developmentally Disabled Services

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