# ELLIS HOUSE OF FITNESS & REHABILITATION CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275814808
- **Authorized official:** JOHN ELLIS (PHYSICAL THERAPY ASSISTANT)
- **Authorized official phone:** (301) 877-8870

## Contact information

- **Practice address:** 7470 OLD ALEXANDRIA FERRY RD, CLINTON, MD 20735-1861
- **Practice address phone:** (301) 877-8870
- **Practice address fax:** (301) 203-0618
- **Mailing address:** 7470 OLD ALEXANDRIA FERRY RD, CLINTON, MD 20735-1861
- **Mailing address phone:** (301) 877-8870
- **Mailing address fax:** (301) 203-0618

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133NN1002X | Nutrition Education Nutritionist | — | NULL | — |
| 133NN1002X | Nutrition Education Nutritionist | — | — | — |
| 174H00000X | Health Educator | — | NULL | — |
| 174H00000X | Health Educator | — | — | — |
| 225XP0019X | Physical Rehabilitation Occupational Therapist | — | NULL | Yes |
| 225XP0019X | Physical Rehabilitation Occupational Therapist | — | — | Yes |
| 302R00000X | Health Maintenance Organization | — | MD | — |

## Other

- **Enumeration date:** 09/09/2011
- **Last updated:** 11/14/2011