Individual
JONATHAN N ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1333 N MAIN ST STE 6, CEDAR CITY, UT 84721-9314
(435) 868-6200
(435) 868-6201
Mailing address
PO BOX 25537, SALT LAKE CITY, UT 84125-0537
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13431730-4201
UT
225X00000X
Occupational Therapist
OT-3209
NV
Other
Enumeration date
04/07/2023
Last updated
06/20/2024
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