Provider Demographics
NPI:1952902330
Name:HARPST, ELLORY MARIE (DPT, PT, CSCS)
Entity Type:Individual
Prefix:DR
First Name:ELLORY
Middle Name:MARIE
Last Name:HARPST
Suffix:
Gender:F
Credentials:DPT, PT, CSCS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3065 SOUTHWESTERN BLVD STE. 108
Mailing Address - Street 2:ORCHARD PARK PROGRESSIVE PHYSICAL THERAPY AT PARKLAND P
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127
Mailing Address - Country:US
Mailing Address - Phone:716-608-6730
Mailing Address - Fax:716-608-6445
Practice Address - Street 1:3065 SOUTHWESTERN BLVD STE. 108
Practice Address - Street 2:ORCHARD PARK PROGRESSIVE PHYSICAL THERAPY AT PARKLAND P
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127
Practice Address - Country:US
Practice Address - Phone:716-608-6730
Practice Address - Fax:716-608-6445
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1163711225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist