Ellarson, Bruce
Ellarson, Bruce is an individual health care provider with primary practice located at 317 Knutson Dr , Madison WI 53704-1133. He recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Technician, Other, which is considered as his primary health care specialty. Ellarson, Bruce can be contacted via phone (608) 301-9337.Contact Information
Primary practice address
317 Knutson Dr
Madison WI 53704-1133
Phone: (608) 301-9337
Fax: (608) 301-9388
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Technologists, Technicians & Other Technical Service Providers / Technician, Other | 247200000X |
Profile Details
| NPI number | 1265519771 |
|---|---|
| LBN Legal business name | Ellarson, Bruce |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 1st, 2006 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265519771 | NPPES |
| Wisconsin | MEDICAID | 41667500 |
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