Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Eric Daniel Ellis, MS, LAT, ATC

Individual provider Athletic Trainer · NPI 1154741692

Mr. Eric Daniel Ellis, MS, LAT, ATC is an Athletic Trainer in Havertown, Pennsylvania. Practices as a sole proprietor. Licensed in Pennsylvania.

Licensed in
PA
In the registry since
2014
What do these letters mean?
MS — Master of Science
A graduate science degree.
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

414 Bryan St
Havertown, PA 19083-4311
Phone: (484) 680-6341
Fax: (610) 359-1686
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence RT004288 (PA)

Record details

NPI number1154741692
Entity typeIndividual (Type 1)
GenderMale
Credentials MS , LAT , ATC
Sole proprietorYes
NPI enumeratedApril 23, 2014
Last updated in NPPESApril 23, 2014

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