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NPI Code Detail

MEDICARE: WILLIAM D ELLIS P.T.

MEDICARE: WILLIAM D ELLIS P.T.
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
1225100000XPhysical Therapist010506OH

General Provider Information

NPI Number : 1811128333
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM D ELLIS P.T.
Provider Business Mailing Address
First Line : 705 SAINT CLAIR ST.
Second Line :
City : NEW LEXINGTON
State : OH
Zip : 43764
Country : US
Telephone Number : 740-343-0283
Fax Number : 740-450-2494
Provider Business Practice Location Address
First Line : 1400 BRANDYWINE BLVD
Second Line :
City : ZANESVILLE
State : OH
Zip : 43701-1083
Country : US
Telephone Number : 740-450-9000
Fax Number : 740-450-2494
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2009
Last Update Date : 07/31/2009

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Directions to “ WILLIAM D ELLIS P.T.” Practice Location

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