Individual
MR. ZACHERY ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
5848 S 300 E, MURRAY, UT 84107-6157
(801) 314-4040
Mailing address
PO BOX 25537, SALT LAKE CITY, UT 84125-0537
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11891337-4201
UT
Other
Enumeration date
09/11/2020
Last updated
03/21/2024
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