Individual
MRS. KERRI PATRICIA ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
626 E SANTIAGO ST, MERIDIAN, ID 83646-6078
(315) 879-8150
Mailing address
626 E SANTIAGO ST, MERIDIAN, ID 83646-6078
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2371
ID
Other
Enumeration date
10/14/2008
Last updated
10/14/2008
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