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General NPI Number Information
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NPI Number | 1942037056
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Entity Type | Individual
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Provider Name | SARAH GREEN ELLIS ND
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Gender | Female
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Dates
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Enumeration Date | 09/14/2024
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Last Update Date | 09/14/2024
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Provider Practice Location Address
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Address Line | 1941 SAVAGE RD STE 100E
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City | CHARLESTON
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State | SC
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Zip | 29407-4788
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Country | US
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Telephone | 843-501-2333
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Fax |
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Provider Business Mailing Address
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Address Line | 3107 SANDERS RD
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City | CHARLESTON
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State | SC
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Zip | 29414-7903
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Country | US
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Telephone | 843-501-2333
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 0155
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License Number State | NH
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