| Doctor Name: | ANTHONY FORREST ELLIS |
| NPI Number: | 1528078300 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | PT 001108 |
| Business Practice Address: | 808 Ward St W Douglas, GA - 315333514 |
| Business Phone Number: | 9123830559 |
| Business Fax Number: | 9123830614 |
| Mailing Address: | Po Box 2150, TIFTON |
| State: | GA |
| Postal Code: | 317932150 |
| Phone Number: | 9123830559 |
| Fax Number: | 9123830614 |
| NPI Enumeration Date: | 08/08/2006 |
| NPI Last Update Date: | 09/07/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT 001108 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| 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 |