Provider Demographics
NPI:1255763306
Name:ELLIS, JOHN FRANCIS (DC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:FRANCIS
Last Name:ELLIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 WATCHUNG AVE
Mailing Address - Street 2:
Mailing Address - City:WATCHUNG
Mailing Address - State:NJ
Mailing Address - Zip Code:07069-4945
Mailing Address - Country:US
Mailing Address - Phone:908-756-2424
Mailing Address - Fax:908-756-2447
Practice Address - Street 1:459 WATCHUNG AVE
Practice Address - Street 2:
Practice Address - City:WATCHUNG
Practice Address - State:NJ
Practice Address - Zip Code:07069-4945
Practice Address - Country:US
Practice Address - Phone:908-756-2424
Practice Address - Fax:908-756-2447
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-31
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH926111N00000X
NJ38MC00727100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor