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General NPI Number Information
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NPI Number | 1235096686
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Entity Type | Individual
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Provider Name | MADISON ELLIS
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Gender | Female
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 104 W 17TH ST
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City | SCHUYLER
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State | NE
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Zip | 68661-1304
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Country | US
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Telephone | 402-352-2441
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Fax |
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Provider Business Mailing Address
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Address Line | 16081 SPRAGUE ST
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City | OMAHA
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State | NE
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Zip | 68116-2829
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 4874
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License Number State | NE
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