Individual provider · Type 1 NPI
Tracy Jo Ellis, LMT
Contractor · Hayden Lake, ID
Practice location
157 W Hayden Ave
Hayden Lake, ID 83835-9650
Mailing address
1628 W Judy K Dr
Rathdrum, ID 83858-7502
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Contractor Primary | 171W00000X | MAS-1492 (ID) |
Contractor: For the purposes of the Health Care Provider Taxonomy, a contractor is limited to individuals who do construction or mechanical work to modify a patient's environment to accommodate a health condition. Contractors perform projects including, but not limited to, building wheelchair ramps, widening doorways, modifying personal vehicles, and making other improvements for patient access and movement. This code has no re…
Another provider at this address
About NPI 1649664442
Tracy Jo Ellis, LMT's National Provider Identifier is 1649664442, issued on Mar 19, 2015. The primary taxonomy on file is Contractor (171W00000X), and the practice location is in Hayden Lake, ID. The record was last updated on Mar 19, 2015.