Individual provider · Type 1 NPI

Kenneth Ray Ellis, MA

Specialist · Johnson City, TN

NPI number 1700103934 Active

Practice location

2243 Eddie Williams Rd
Johnson City, TN 37601-2872

Call (423) 928-5627 Map

Fax (423) 467-3644

Mailing address

1167 Spratlin Park Dr
Gray, TN 37615-6205

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XNone listed

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1700103934

Kenneth Ray Ellis, MA's National Provider Identifier is 1700103934, issued on Apr 28, 2010. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Johnson City, TN. The record was last updated on Apr 28, 2010.