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Logan Ellis
NPI 1568900769 · on the registry since 2017 · sole proprietor
Practice
- Address
- 703 S Americana Blvd Ste 120
Boise, ID 83702 - Phone
- (208) 489-5543
- Clinicians at this address
- 35
Additional practice sites
- 520 W Spruce St Apt A203, Missoula, MT
- 520 W Spruce St Apt A203, Missoula, MT
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2018-03-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho