person
Jay T Ellis, PT,DPT,CSCS
Contractor in Idaho Falls, Idaho
NPI 1811924012

Jay T Ellis is a Contractor based in Idaho Falls, ID. Jay T Ellis practices in Idaho Falls, ID and has the professional credentials of PT,DPT,CSCS. The NPI Number for Jay T Ellis is 1811924012 and holds a License No. RPT231 (Idaho).

The current practice location address for Jay T Ellis is 3100 S Woodruff Ave, Idaho Falls, ID and can be reached out via phone at 208-523-8879 and via fax at 208-523-0436.

Location: 3100 S Woodruff Ave, Idaho Falls, ID, 83403-1463
person
Provider Profile Details
NPI Number
1811924012
Provider Name
Jay T Ellis
Credential
PT,DPT,CSCS
Provider Entity Type
Individual
Gender
Male
Address
3100 S Woodruff Ave, Idaho Falls, ID, 83403-1463
Phone Number
208-523-8879
Fax Number
208-523-0436
Provider Enumeration Date
06/26/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
316942 01 ID BLUE SHIELD
804274500 05 ID
T0742 01 ID BLUE CROSS OF IDAHO
institution
Provider Business Practice Location Address Details
Address
3100 S Woodruff Ave
City
State
Zip
83404-8310
Phone Number
208-523-8879
Fax Number
208-523-0436
person
Provider Business Mailing Address Details
Address
3100 S Woodruff Ave
City
State
Zip
83404-8310
Phone Number
208-523-8879
Fax Number
208-523-0436
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Contractor
Speciality
-
Taxonomy
License No.
RPT231 (Idaho)
Definition
A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering).
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