Provider Demographics
NPI:1467026815
Name:ISAAC, ELLEN MICHELLE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:MICHELLE
Last Name:ISAAC
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1139 BELVEDERE ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-1701
Mailing Address - Country:US
Mailing Address - Phone:419-775-6925
Mailing Address - Fax:
Practice Address - Street 1:12613 TAYLORSVILLE RD STE 118
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-5496
Practice Address - Country:US
Practice Address - Phone:502-267-1480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
KY009249225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist