Ellis, Charles Michael

Ellis, Charles Michael is an individual health care provider with primary practice located at 2000 Berry Chase Pl , Montgomery AL 36117-6896. 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. Ellis, Charles Michael can be contacted via phone (334) 356-6453.

Contact Information

Primary practice address
2000 Berry Chase Pl Montgomery AL 36117-6896
Phone: (334) 356-6453
Fax: (334) 239-8126
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PTH1388 Alabama

Profile Details

NPI number 1134165343
LBN Legal business name Ellis, Charles Michael
Credentials P.T., ATC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Jan 4th, 2022 - about 3 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 1134165343 NPPES
Alabama MEDICAID 890013760

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