Individual
MISS JANA ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4969 SYCAMORE DR, EAGAN, MN 55123-4913
(651) 366-9333
Mailing address
4969 SYCAMORE DR, EAGAN, MN 55123-4913
(651) 366-9333
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
225X00000X
Occupational Therapist
Primary
106713
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/07/2016
Last updated
01/07/2025
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