Provider Demographics
NPI:1558431221
Name:ELLIOTT, JULIE L
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:L
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 S ROOSEVELT ST
Mailing Address - Street 2:STE 3
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-6593
Mailing Address - Country:US
Mailing Address - Phone:605-725-5502
Mailing Address - Fax:605-725-5501
Practice Address - Street 1:634 S ROOSEVELT ST
Practice Address - Street 2:STE 3
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-6593
Practice Address - Country:US
Practice Address - Phone:605-725-5502
Practice Address - Fax:605-725-5501
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath