Individual
GREGORY S ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
7801 YORK RD STE 104, TOWSON, MD 21204-7446
(410) 337-4024
(443) 991-4582
Mailing address
8322 BELLONA AVE STE 100, TOWSON, MD 21204-2065
(410) 337-7900
(410) 769-8591
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
27007
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27007
PT LICENSE
MD
Enumeration date
06/01/2018
Last updated
06/01/2018
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