Provider Demographics
NPI:1366639403
Name:ELIAS, ALIA L (ND, MSOM)
Entity Type:Individual
Prefix:
First Name:ALIA
Middle Name:L
Last Name:ELIAS
Suffix:
Gender:F
Credentials:ND, MSOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 TRAINING FIELD RD
Mailing Address - Street 2:
Mailing Address - City:WEST NEWBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01985-1101
Mailing Address - Country:US
Mailing Address - Phone:978-510-1519
Mailing Address - Fax:
Practice Address - Street 1:2 TRAINING FIELD RD
Practice Address - Street 2:
Practice Address - City:WEST NEWBURY
Practice Address - State:MA
Practice Address - Zip Code:01985-1101
Practice Address - Country:US
Practice Address - Phone:978-510-1519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171100000X
NH63175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No175F00000XOther Service ProvidersNaturopath