Ellis, Jennifer L

Ellis, Jennifer L is an individual health care provider with primary practice located at 7440 N Shadeland Ave Suite 130, Indianapolis IN 46250-2029. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Ellis, Jennifer L can be contacted via phone (317) 577-7333.

Contact Information

Primary practice address
7440 N Shadeland Ave Suite 130 Indianapolis IN 46250-2029
Phone: (317) 577-7333
Fax: (317) 577-7330
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 05004851A Indiana

Profile Details

NPI number 1225016934
LBN Legal business name Ellis, Jennifer L
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2006
Last updated Jul 9th, 2007 - about 19 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 1225016934 NPPES
Indiana Other 05004851A PHYSICAL THERAPIST LICENS

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