Individual provider · Type 1 NPI

Jay T. Ellis, PT, DPT, CSCS

Contractor · Idaho Falls, ID

NPI number 1811924012 Active

Practice location

3100 S Woodruff Ave
Idaho Falls, ID 83404-8310

Call (208) 523-8879 Map

Fax (208) 523-0436

Mailing address

PO Box 1463
Idaho Falls, ID 83403-1463

Specialties and licenses

TaxonomyCodeLicense
Contractor Primary 171W00000XRPT231 (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…

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About NPI 1811924012

Jay T. Ellis, PT, DPT, CSCS's National Provider Identifier is 1811924012, issued on Jun 26, 2006. The primary taxonomy on file is Contractor (171W00000X), and the practice location is in Idaho Falls, ID. The record was last updated on Mar 4, 2011.