NPI 1154741692

Eric Daniel Ellis, MSLATATC

Practitioner Athletic Trainer Havertown, PA

Practice location

Address: 414 Bryan St, Havertown, PA 19083-4311
Phone: (484) 680-6341
Fax: (610) 359-1686

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence RT004288 (PA)

Other Specialist/Technologist providers in Pennsylvania →

Registry record

NPI: 1154741692
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Apr 2014
Record last updated: 23 Apr 2014

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.