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General NPI Number Information
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NPI Number | 1437761590
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Entity Type | Organization
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Legal Business Name | DR. WHITNEY M. ELLSWORTH, DPT, PLLC
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Dates
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Enumeration Date | 08/20/2020
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 2601 N ASPEN AVE STE 1023
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City | BROKEN ARROW
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State | OK
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Zip | 74012-1378
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Country | US
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Telephone | 918-486-9977
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Fax | 539-777-2529
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Provider Business Mailing Address
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Address Line | 2601 N ASPEN AVE STE 1023
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City | BROKEN ARROW
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State | OK
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Zip | 74012-1378
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Country | US
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Telephone | 918-486-9977
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Fax | 539-777-2529
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | DR. WHITNEY ELLSWORTH
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Credential | DPT
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Telephone | 918-486-9977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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