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Individual

MR. DAVID L ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
115 S MURCHISON ST, ATHENS, TX 75751-2662
(903) 675-0000
(903) 675-5520
Mailing address
115 S MURCHISON ST, ATHENS, TX 75751-2662
(903) 675-0000
(903) 675-5520

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1024776
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7416339
BCBS BLUE LINK #
TX
01
81584T
BCBS PAR PLAN
TX
Enumeration date
08/09/2006
Last updated
02/08/2010
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