Ellingworth, Brian Jon

Ellingworth, Brian Jon is an individual health care provider with primary practice located at 1431 Premier Dr , Mankato MN 56001-6076. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Ellingworth, Brian Jon can be contacted via phone (507) 386-6700.

Contact Information

Primary practice address
1431 Premier Dr Mankato MN 56001-6076
Phone: (507) 386-6700
Fax: (507) 388-8372
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 3052 Minnesota

Profile Details

NPI number 1861450504
LBN Legal business name Ellingworth, Brian Jon
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Jul 22nd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861450504 NPPES
Minnesota Other 103183C572 UCARE MN
Minnesota Other 6404967 UCARE MN
Minnesota Other 983181027668 UCARE MN
Minnesota Other 11F45EL UCARE MN
Minnesota Other 6404857 UCARE MN
Minnesota Other H035 UCARE MN
Minnesota Other HP43586 UCARE MN

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