Individual
CHRISTOPHER RAY ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1838 W PARKSIDE LN STE 110, PHOENIX, AZ 85027-1370
(480) 454-4698
(480) 454-4699
Mailing address
PO BOX 5718, KALISPELL, MT 59903-5718
(406) 756-0136
(406) 300-1612
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11359
AZ
225100000X
Physical Therapist
7409
AZ
225100000X
Physical Therapist
9914
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153812
—
AZ
Enumeration date
10/04/2006
Last updated
12/14/2020
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