Individual
DAVID EDWARD ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1007 GOODYEAR AVE, REHABILITATION SERVICES DEPARTMENT, GADSDEN, AL 35903-1195
(256) 494-4000
(256) 494-4667
Mailing address
1007 GOODYEAR AVE, REHABILITATION SERVICES DEPARTMENT, GADSDEN, AL 35903-1195
(256) 494-4000
(256) 494-4667
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5824
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
510-37296ELL
BCBS
AL
Enumeration date
09/03/2010
Last updated
09/03/2010
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