Individual
ELLIOTT LAUDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
100 DOGWOOD DR, PHILIPSBURG, PA 16866-1982
(814) 342-8434
Mailing address
475 S CENTRE ST, PHILIPSBURG, PA 16866-2957
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP007799
PA
Other
Enumeration date
01/15/2018
Last updated
01/15/2018
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