MEDICARE: ZACHARY ELLIS DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NN0400X	Neurology Chiropractor	CR3078	ME

General Provider Information

NPI Number	:	1760287122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACHARY ELLIS DC

Provider Business Mailing Address
First Line	:	464 HILLSIDE AVE
Second Line	:	SUITE 211
City	:	DEEDHAM
State	:	MA
Zip	:	02790
Country	:	US
Telephone Number	:	978-429-8952
Fax Number	:

Provider Business Practice Location Address
First Line	:	464 HILLSIDE AVE STE 211
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02494-1228
Country	:	US
Telephone Number	:	978-429-8952
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2025
Last Update Date	:	01/06/2026

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Directions to “ ZACHARY ELLIS DC” Practice Location

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