JAY T ELLIS

IDAHO FALLS, ID
NPI1811924012
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy171W00000X Contractor
(Licence: ID  RPT231)
Enumeration Date2006-06-26
Last Update Date2011-03-04
Business Address
-- JAY T ELLIS PT, DPT, CSCS
3100 S WOODRUFF AVE
IDAHO FALLS, ID 83404-8310
Phone number: 208-523-8879
Mailing Address
-- JAY T ELLIS PT, DPT, CSCS
PO BOX 1463
IDAHO FALLS, ID 83403-1463
Phone number: 208-523-8879