Individual
BENJAMIN WILLIAM SPENCER ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
114 GRAND RESERVE DR, PELHAM, AL 35124-1272
(256) 591-0017
Mailing address
5037 RED OAK DR, OXFORD, AL 36203-3350
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1939
AL
Other
Enumeration date
11/01/2016
Last updated
03/22/2018
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