MRS. Heidi Lynn Ellwood, MPT

NPI #1386766335 in Dixon, Missouri

Provider Information

NPI Number: 1386766335
Entity Type: Individual
Name: MRS. Heidi Lynn Ellwood, MPT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: MPT
Enumeration Date: Apr 3, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 20270 HARLEQUIN LN
City: Dixon
State: Missouri
ZIP Code: 65459-7524
Phone: (573) 336-4965

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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