Ellis Physical Therapy P A

LBN: Ellis Physical Therapy P A
Ellis Physical Therapy P A is an health care organization with primary practice located at 3100 S Woodruff Ave , Idaho Falls ID 83404-8310. The organization recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as the primary health care specialty. Ellis Physical Therapy P A can be contacted via phone (208) 523-8879, or through Larsen, Terri L via phone (208) 523-8879.

Contact Information

Primary practice address
3100 S Woodruff Ave Idaho Falls ID 83404-8310
Phone: (208) 523-8879
Fax: (208) 523-0436
Website:
Map and Directions
Authorized official contact:
Name: Larsen, Terri L
Phone: (208) 523-8879

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X

Profile Details

NPI number 1518203249
LBN Legal business name Ellis Physical Therapy P A
DBA Doing business as
Authorized official Larsen, Terri L
Entity Organization
Organization subpart 1 No
Enumeration date Dec 28th, 2012
Last updated Apr 20th, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518203249 NPPES
Idaho MEDICAID 804274500

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