Organization
AT HOME PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA A ELLIS PT (OWNER)
(810) 796-9102
Entity
Organization
Contact information
Practice address
5654 BELLE RIDGE CT, DRYDEN, MI 48428-9240
(810) 796-9102
Mailing address
5654 BELLE RIDGE CT, DRYDEN, MI 48428-9240
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501010803
MI
Other
Enumeration date
07/17/2006
Last updated
08/22/2020
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