| Jonathan N Ellis, OTR/L | |
|
1333 N Main St Ste 6, Cedar City, UT 84721-9314 | |
| (435) 868-6200 | |
| (435) 868-6201 |
| Full Name | Jonathan N Ellis |
|---|---|
| Gender | Male |
| Speciality | Occupational Therapist |
| Location | 1333 N Main St Ste 6, Cedar City, Utah |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124713821 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 13431730-4201 (Utah) | Primary |
| 225X00000X | Occupational Therapist | OT-3209 (Nevada) | Secondary |
| Provider Name | Ihc Health Services Inc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1033822085 PECOS PAC ID: 1850209420 Enrollment ID: O20230627000064 |
| Mailing Address | Practice Location Address |
|---|---|
| Jonathan N Ellis, OTR/L Po Box 25537, Salt Lake City, UT 84125-0537 Ph: () - | Jonathan N Ellis, OTR/L 1333 N Main St Ste 6, Cedar City, UT 84721-9314 Ph: (435) 868-6200 |
Barbara Jill Spencer, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1303 N Main St, Cedar City, UT 84721 Phone: 434-868-6200 | |
Garland Earwood, O.T. R. L. Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 166 W 1325 N, Ste 100, Cedar City, UT 84720 Phone: 435-586-0064 Fax: 435-867-1243 | |
Kasidee Danielle Passey, OTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 1303 N Main St, Cedar City, UT 84721 Phone: 435-868-5000 | |
Chad R Fletcher, O.T.R.L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 166 W 1325 N, Ste 100, Cedar City, UT 84720 Phone: 435-586-0064 Fax: 435-867-1243 | |
Colton Savage, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1303 N Main St, Cedar City, UT 84721 Phone: 435-868-5000 | |
Peter Kennedy Wallace, OTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 166 W 1325 N Ste 100, Cedar City, UT 84721 Phone: 435-586-0064 |