# ELLIS PHYSICAL THERAPY ASSOCIATES, INC.

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

## Provider details

- **NPI number:** 1306169446
- **Authorized official:** MS. CYNTHIA ELLIS PT (PRESIDENT)
- **Authorized official phone:** (803) 783-0684

## Contact information

- **Practice address:** 6041 GARNERS FERRY RD, SUITE B, COLUMBIA, SC 29209
- **Practice address phone:** (803) 783-0684
- **Practice address fax:** (803) 783-1147
- **Mailing address:** PO BOX 11400, COLUMBIA, SC 29211-1400
- **Mailing address phone:** (803) 794-2213
- **Mailing address fax:** (803) 791-5284

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 285 | SC | Yes |

## Other

- **Enumeration date:** 03/03/2010
- **Last updated:** 05/27/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 426542 | MEDICARE | SC |