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HEATHER RENEE ELLIS PT, DPT
>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1053898759
Individual Registrant: HEATHER RENEE ELLIS PT, DPT
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
62 CARRIAGE OAKS DR TYRONE, GA 30290 US
Tel: 770-969-7166 Fax: 770-969-7168
Tel: 770-969-7166 Fax: 770-969-7168
Contact information for business:
6397 LEE HWY STE 300 CHATTANOOGA, TN 37421-2564 US
Tel: 423-238-7217 Fax: 423-362-8684
Tel: 423-238-7217 Fax: 423-362-8684
Registration Information:
NPI: 1053898759
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapist | GA | PT013604 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
