SearchGeorgia101YP2500X

Dorian Ellis

NPI 1912522582 · on the registry since 2020 · sole proprietor

Practice

Address
5470 Lemoyne Dr Sw
Atlanta, GA 30331
Phone
(617) 331-6966

Registry record

Primary taxonomy
101YP2500X
101YP2500X
Licence states on file
GA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2020-06-10

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 Georgia