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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265404388 NPPES
Nevada MEDICAID 1265404388
Nevada Other DL668Z

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