Individual
MEREDITH ELLERBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
714 W GROVE ST, EL DORADO, AR 71730-4416
(870) 863-8194
(870) 881-4619
Mailing address
714 W GROVE ST, EL DORADO, AR 71730-4416
(870) 863-8194
(870) 881-4619
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 2044
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158606721
—
AR
Enumeration date
02/22/2011
Last updated
02/22/2011
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