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Individual

ABIGAIL CLAIRE ELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-2885
Mailing address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10387432-2401
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
312816
ALLEGRA
Enumeration date
11/06/2017
Last updated
12/03/2021
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