Individual
ISRAEL ELLERBROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
615 LILLY RD NE STE 240, OLYMPIA, WA 98506-5117
(360) 413-3850
Mailing address
2314 COOPER CREST ST NW, OLYMPIA, WA 98502-4032
(831) 207-0828
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P160835239
WA
Other
Enumeration date
08/24/2024
Last updated
08/24/2024
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