Organization
INNOVATIVE PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH ELLIS DPT (OWNER)
(219) 926-5850
Entity
Organization
Contact information
Practice address
502 E 1100 N, CHESTERTON, IN 46304-9697
(219) 926-5850
(219) 250-2072
Mailing address
502 E 1100 N, CHESTERTON, IN 46304-9697
(219) 926-5850
(219) 250-2072
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05010042A
IN
Other
Enumeration date
11/16/2015
Last updated
12/23/2020
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