Organization
ELLIS PHYSICAL THERAPY ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA ELLIS PT (PRESIDENT)
(803) 783-0684
Entity
Organization
Contact information
Practice address
6041 GARNERS FERRY RD, SUITE B, COLUMBIA, SC 29209
(803) 783-0684
(803) 783-1147
Mailing address
PO BOX 11400, COLUMBIA, SC 29211-1400
(803) 794-2213
(803) 791-5284
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
285
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
426542
MEDICARE
SC
Enumeration date
03/03/2010
Last updated
05/27/2021
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