Provider Demographics
NPI:1083496343
Name:ELLIOTT, JAMES FRANKLIN (OTR/L)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:FRANKLIN
Last Name:ELLIOTT
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 WILL DENT RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-8139
Mailing Address - Country:US
Mailing Address - Phone:803-600-1425
Mailing Address - Fax:
Practice Address - Street 1:5422 AUGUSTA RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-3892
Practice Address - Country:US
Practice Address - Phone:803-756-3068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1551225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist