Provider Demographics
NPI:1649599465
Name:ELDER, ELIZABETH EVE (PHD, LAT, ATC)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:EVE
Last Name:ELDER
Suffix:
Gender:F
Credentials:PHD, LAT, ATC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:EVE
Other - Last Name:HIBBERD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, LAT, ATC
Mailing Address - Street 1:270 KILGORE LANE BOX 870325
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35487-0001
Mailing Address - Country:US
Mailing Address - Phone:704-576-1393
Mailing Address - Fax:
Practice Address - Street 1:270 KILGORE LANE OFFICE 2109
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35487-4441
Practice Address - Country:US
Practice Address - Phone:205-348-7320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16582255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer