| |
1838 W Parkside Ln Ste 110, Phoenix, AZ 85027-1370 | |
(970) 712-2938 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Clinic/center - Physical Therapy |
Location | 1838 W Parkside Ln Ste 110, Phoenix, Arizona |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568079523 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Secondary |
261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
Provider Name | Christopher R Ellis |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1497841167 PECOS PAC ID: 0244238830 Enrollment ID: I20061114000495 |
Provider Name | Jennifer Mcclendon |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1871087718 PECOS PAC ID: 7911254909 Enrollment ID: I20180723000892 |
Mailing Address | Practice Location Address |
---|---|
Po Box 5718, Kalispell, MT 59903-5718 Ph: (406) 756-0134 | 1838 W Parkside Ln Ste 110, Phoenix, AZ 85027-1370 Ph: (970) 712-2938 |