Provider Demographics
NPI:1164523684
Name:MARKWELL, ELLEN EVANS (PT)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:EVANS
Last Name:MARKWELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:EVANS
Other - Last Name:MARKWELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:7655 POPLAR AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3960
Mailing Address - Country:US
Mailing Address - Phone:901-516-6929
Mailing Address - Fax:901-516-6649
Practice Address - Street 1:7655 POPLAR AVE STE 250
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3960
Practice Address - Country:US
Practice Address - Phone:901-516-6929
Practice Address - Fax:901-516-6649
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001169261QP2000X
TNPT1169225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy