Ellis, Douglas A
Ellis, Douglas A is an individual health care provider with primary practice located at 3233 W Charleston Blvd Ste 107, Las Vegas NV 89102-1938. 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, Douglas A can be contacted via phone (702) 258-9381.Contact Information
Primary practice address
3233 W Charleston Blvd Ste 107
Las Vegas NV 89102-1938
Phone: (702) 258-9381
Fax: (702) 258-9584
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 0149 | Nevada |
Profile Details
| NPI number | 1265404388 |
|---|---|
| LBN Legal business name | Ellis, Douglas A |
| Credentials | PHYSICAL THERAPIST |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 2nd, 2006 |
| Last updated | Sep 3rd, 2015 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265404388 | NPPES |
| Nevada | MEDICAID | 1265404388 | |
| Nevada | Other | DL668Z |
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