Individual
ANITA ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
45TH SIX SIXTY STREET, SHENANDOAH JUNCTION, WV 25442-0117
(304) 761-9385
Mailing address
PO BOX 117, SHENANDOAH JUNCTION, WV 25442-0117
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
12/11/2020
Last updated
12/11/2020
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