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Individual

DUSTIN K ELLIOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
1005 W 6TH S, MOUNTAIN HOME, ID 83647-3339
(208) 587-1777
(208) 587-1784
Mailing address
7550 W EMERALD ST, BOISE, ID 83704-9015
(208) 375-0666
(208) 375-2996

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3243
ID

Other

Enumeration date
05/29/2013
Last updated
05/29/2013
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