Provider Demographics
NPI:1083830681
Name:FURR, ELLEN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:FURR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3485 HIDDEN HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-3819
Mailing Address - Country:US
Mailing Address - Phone:928-556-8664
Mailing Address - Fax:928-779-2331
Practice Address - Street 1:3485 HIDDEN HOLLOW RD
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-3819
Practice Address - Country:US
Practice Address - Phone:928-556-8664
Practice Address - Fax:928-779-2331
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0866225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist