KENNETH RAY ELLIS MA NPI 1700103934

NPI Information

Kenneth Ray Ellis, MA is a specialist in Johnson City, TN. The provider is 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. Kenneth Ray Ellis, MA NPI is 1700103934. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2243 EDDIE WILLIAMS RD
JOHNSON CITY, TN
ZIP 37601-872
Phone: (423) 928-5627
Fax: (423) 467-3644

The enumeration date for this NPI number is 4/28/2010 and was last updated on 4/28/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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