NPI 1114388303

Timothy Ellis, ATC

Practitioner Athletic Trainer Wayne, NE

Practice location

Address: 1200 Providence Rd, Wayne, NE 68787-1212
Phone: (402) 375-7937
Fax: (402) 375-7956

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 54 (NE)

Other Specialist/Technologist providers in Nebraska →

Registry record

NPI: 1114388303
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Mar 2016
Record last updated: 15 Mar 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.