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Organization
LIVINGSTON PHYSICAL THERAPY PC
Active
Organization
LIVINGSTON PHYSICAL THERAPY PC
Active
Other names
Vivian B. Ellis, LPT Livingston Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSIE CLARKE DPT (PRESIDENT, OWNER/P.T.)
(936) 327-4084
Entity
Organization
Contact information
Practice address
305 W MILL ST, LIVINGSTON, TX 77351-3299
(936) 327-4084
(936) 327-1201
Mailing address
305 W MILL ST, LIVINGSTON, TX 77351-3299
(936) 327-4084
(936) 327-1201
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0070HE
BCBS PAR PLAN
TX
05
—
109663801
—
TX
Enumeration date
05/23/2005
Last updated
01/29/2026
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