Doctor Name: | DR. BRANDON GRAHAM ELLISON |
NPI Number: | 1073866638 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.T. |
License Number: | 24155 |
Business Practice Address: | 719 Maiden Choice Ln Catonsville, MD - 212286138 |
Business Phone Number: | 4107378859 |
Business Fax Number: | 4107378836 |
Mailing Address: | 719 Maiden Choice Ln, CATONSVILLE |
State: | MD |
Postal Code: | 212286138 |
Phone Number: | 4107378859 |
Fax Number: | 4107378836 |
NPI Enumeration Date: | 10/19/2012 |
NPI Last Update Date: | 10/19/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 24155 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |