Basic Information
| Provider Information | |||||||||
| NPI: | 1396137303 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ELLIOTT | ||||||||
| FirstName: | VALERIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 650 LAKE RD | ||||||||
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| City: | ATWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 677301535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8888734221 | ||||||||
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| Practice Location | |||||||||
| Address1: | 650 LAKE RD | ||||||||
| Address2: | |||||||||
| City: | ATWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 677301535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8888734221 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2015 | ||||||||
| LastUpdateDate: | 02/27/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 14-02613 | KS | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.