Individual
EVAN GIBSON BAITY ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2545 CAPITAL AVE SW, BATTLE CREEK, MI 49015-7120
(266) 979-3000
(239) 979-9770
Mailing address
1521 GULL RD, KALAMAZOO, MI 49048-1640
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501016414
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55010106414
—
MI
Enumeration date
03/14/2018
Last updated
06/11/2024
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