Doctor Name: | MR. JON DAVID ELY |
NPI Number: | 1275619538 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 5501008405 |
Business Practice Address: | 5590 Main St. Suite 4 Lexington, MI - 48450 |
Business Phone Number: | 8103598700 |
Business Fax Number: | 8103598702 |
Mailing Address: | Po Box 416, 5590 Main Street , Suite 4 LEXINGTON |
State: | MI |
Postal Code: | 484500416 |
Phone Number: | 8103598700 |
Fax Number: | 8103598702 |
NPI Enumeration Date: | 10/30/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5501008405 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
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 |