MR. ELLIS RAY TACKETT ATC LAT NPI 1821489576

NPI Information

MR. Ellis Ray Tackett, ATC LAT is a specialist in Pikeville, KY. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MR. Ellis Ray Tackett, ATC LAT NPI is 1821489576. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

147 SYCAMORE ST
PIKEVILLE, KY
ZIP 41501-118
Phone: (606) 213-1620
Fax: (606) 218-5353

The enumeration date for this NPI number is 2/16/2015 and was last updated on 2/16/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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