Individual
JIM THOMAS ELLERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
210 WEST AVE, LEVELLAND, TX 79336-3233
(806) 894-5053
(806) 894-9603
Mailing address
210 WEST AVE, LEVELLAND, TX 79336-3233
(806) 894-5053
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2031342
TX
Other
Enumeration date
09/06/2018
Last updated
09/06/2018
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