| Ellerbrock Spine And Soft Tissue Services Llc | |
|
120 N Main St Suite A Bluffton OH 45817-1246 | |
| (419) 358-2222 | |
| (419) 358-2223 |
| Full Name | Ellerbrock Spine And Soft Tissue Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 120 N Main St, Bluffton, Ohio |
| Authorized Official Name and Position | Matthew P Ellerbrock (OWNER) |
| Authorized Official Contact | 4196592271 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellerbrock Spine And Soft Tissue Services Llc 120 N. Main St. Bluffton OH 45817-1250 Ph: (419) 358-2222 | Ellerbrock Spine And Soft Tissue Services Llc 120 N Main St Suite A Bluffton OH 45817-1246 Ph: (419) 358-2222 |
| NPI Number | 1205205259 |
|---|---|
| Provider Enumeration Date | 09/21/2015 |
| Last Update Date | 02/10/2016 |
| Medicare PECOS PAC ID | 2466762356 |
|---|---|
| Medicare Enrollment ID | O20160217000028 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205205259 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2927 (Ohio) | Primary |
| Provider Name | Matthew P Ellerbrock |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1417021692 PECOS PAC ID: 3375727035 Enrollment ID: I20110405000761 |
| Provider Name | Megan Marie Brodwolf |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1700021086 PECOS PAC ID: 2668820887 Enrollment ID: I20231129001439 |
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