Individual
BRIAN ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
3131 S MAIN ST, MOULTRIE, GA 31768-6925
(229) 890-3514
Mailing address
PO BOX 934, MOULTRIE, GA 31776-0934
(229) 890-3514
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN109322
GA
Other
Enumeration date
08/28/2014
Last updated
06/29/2016
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