| Doctor Name: | BENJAMIN ELLENBERGER |
| NPI Number: | 1215303979 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 2305209652 |
| Business Practice Address: | 2114 Angus Rd Suite 107 Charlottesville, VA - 229012768 |
| Business Phone Number: | 4342954473 |
| Business Fax Number: | 4342952691 |
| Mailing Address: | 430 Innovation Dr, BLAIRSVILLE |
| State: | PA |
| Postal Code: | 157178096 |
| Phone Number: | 7243434060 |
| Fax Number: | 7243434069 |
| NPI Enumeration Date: | 08/18/2015 |
| NPI Last Update Date: | 08/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2305209652 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| 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 |