Individual
MR. FRED STEVEN ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
552 WILSON AVE, COSHOCTON, OH 43812-2358
(740) 575-6564
(740) 722-9008
Mailing address
552 WILSON AVE, COSHOCTON, OH 43812-2358
(740) 575-6564
(740) 722-9008
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
RP532801
OH
Other
Enumeration date
02/07/2019
Last updated
02/07/2019
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