Individual
DAVID T ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M
Contact information
Practice address
4121 E VALLEY AUTO DR, STE 110, MESA, AZ 85206-4632
(480) 892-1540
(480) 892-2243
Mailing address
9233 E NEVILLE AVE, UNIT 1033, MESA, AZ 85209-1505
(480) 310-6015
(480) 892-2243
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
0786
AZ
213ES0000X
Sports Medicine Podiatrist
0786
AZ
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0786
AZ
Other
Enumeration date
07/07/2011
Last updated
05/05/2016
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