Most Relevant Information
Provider Data
| NPI Number: | 1003431867 |
| Provider Name: | JENNIFER ANNE ELLIS PT, DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | PT021920 |
Most Important Dates
| Enumeration Date: | 06/08/2020 |
| Last Updated: | 06/08/2020 |
Provider Practice Location
1923 BAINBRIDGE ST
PHILADELPHIA
PA
191461430
Practice Location Phone/Fax
| Phone: | 2154691832 |
| Fax: |
Provider Mailing Location
1923 BAINBRIDGE ST
PHILADELPHIA
PA
191461430
Provider Mailing Phone/Fax
| Phone: | 2154691832 |
| Fax: |