Individual
MATTHEW CHRISTIAN ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4602 EASTPARK BLVD, MADISON, WI 53718-2002
(608) 440-6287
Mailing address
1868 E WASHINGTON AVE, APT 575, MADISON, WI 53704
(845) 453-4004
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
16319-24
WI
Other
Enumeration date
07/06/2023
Last updated
07/06/2023
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