Organization
ELLIS PHYSICAL THERAPY AND ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOGAN BRADLEY DPT (OWNER)
(208) 523-8879
Entity
Organization
Contact information
Practice address
3100 S WOODRUFF AVE, IDAHO FALLS, ID 83404-8310
(208) 523-8879
Mailing address
3100 S WOODRUFF AVE, IDAHO FALLS, ID 83404-8310
(208) 523-8879
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
01/21/2020
Last updated
01/21/2020
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