| Doctor Name: | DR. JESSE CHRISTOPHER ELLWEIN |
| NPI Number: | 1609186964 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPT |
| License Number: | PTL-10984 |
| Business Practice Address: | Baumholder Health Clinic - Unit 23809 Cmr 405 Box #52 Apo, AE - 09034 |
| Business Phone Number: | 490678366357 |
| Business Fax Number: | |
| Mailing Address: | Landstuhl Regional Medical Center, Cmr 402 APO |
| State: | AE |
| Postal Code: | 09180 |
| Phone Number: | 496371868590 |
| Fax Number: | |
| NPI Enumeration Date: | 10/20/2010 |
| NPI Last Update Date: | 10/20/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PTL-10984 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| 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 |