Mallory Loretta Elting, PTA

Individual provider Active NPI Physical Therapy Assistant · Nelson, NE

NPI 1962686246 · NPPES record last updated Dec 22, 2007

Key facts

NPI
1962686246
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
816 (NE)
Practice address
3735 Road V
Nelson, NE 68961-8727
Phone
(402) 984-9169
NPI assigned
Dec 22, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
816NEMDOrthopaedic Surgery Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 816 NE Yes

Addresses

Primary practice location

3735 Road V
Nelson, NE 68961-8727

Mailing address

3735 Road V
Nelson, NE 68961-8727
Phone (402) 984-9169

Other providers in Nelson, NE

All providers in Nelson, NE · Physical Therapy Assistant in Nebraska

Sources for this page

Verify at the official NPI Registry.