NPI 1932837614

Daniel Ellis

Practitioner Driver Lake Charles, LA

Practice location

Address: 1400 Jackson St, Lake Charles, LA 70601-2458
Phone: (337) 488-9560

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence 010630340 (LA)

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Registry record

NPI: 1932837614
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Aug 2022
Record last updated: 10 Aug 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.