Jay T Ellis, PT, DPT, CSCS

NPI #1811924012 in Idaho Falls, Idaho

Provider Information

NPI Number: 1811924012
Entity Type: Individual
Name: Jay T Ellis, PT, DPT, CSCS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Contractor
Credential: PT, DPT, CSCS
Enumeration Date: Jun 26, 2006
Last Updated: Mar 4, 2011

Practice Location

Address: 3100 S WOODRUFF AVE
City: Idaho Falls
State: Idaho
ZIP Code: 83404-8310
Phone: (208) 523-8879

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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