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NPI 1942548300

NPI 1942548300 : HELEN ELLETT P.T. : VICTORIA, TX

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General NPI Number Information
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    NPI Number           |    1942548300
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    Entity Type          |    Individual 
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    Provider Name        |    HELEN ELLETT P.T.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/19/2013
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    Last Update Date     |    01/19/2013
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Provider Practice Location Address
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    Address Line         |    6102 COUNTRY CLUB DR 
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    City                 |    VICTORIA
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    State                |    TX
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    Zip                  |    77904-1671
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    Country              |    US
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    Telephone            |    361-894-5571
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6102 COUNTRY CLUB DR 
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    City                 |    VICTORIA
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    State                |    TX
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    Zip                  |    77904-1671
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    Country              |    US
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    Telephone            |    361-894-5571
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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       |    1121986
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    License Number State |    TX
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