Individual
DEREK ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1114 COMMONS BLVD, READING, PA 19605-3333
(610) 926-0960
Mailing address
3752 WINBURNE MUNSON RD, MORRISDALE, PA 16858-8703
(814) 553-8834
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT026224
PA
Other
Enumeration date
08/04/2017
Last updated
08/04/2017
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