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:
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Health care specialties

SpecialtyCodeLicense #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 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265519771 NPPES
Wisconsin MEDICAID 41667500

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