Provider Demographics
NPI:1295007706
Name:PERLOW, ELLEN R (PT)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:R
Last Name:PERLOW
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:3001 MERCER UNIVERSITY DR
Mailing Address - Street 2:SUITE 106 DAVIS BUILDING
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-4115
Mailing Address - Country:US
Mailing Address - Phone:678-547-6439
Mailing Address - Fax:678-547-6710
Practice Address - Street 1:3001 MERCER UNIVERSITY DR
Practice Address - Street 2:SUITE 106 DAVIS BUILDING
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-4115
Practice Address - Country:US
Practice Address - Phone:678-547-6439
Practice Address - Fax:678-547-6710
Is Sole Proprietor?:No
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA003587225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist