Individual
DR. BERNICE LORRAINE ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
541 KENOSHA ST, WALWORTH, WI 53184-9538
(262) 275-1700
Mailing address
730 ANN ST, LAKE GENEVA, WI 53147-1418
(262) 348-9294
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3166-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38927700
—
WI
Enumeration date
08/04/2006
Last updated
07/08/2007
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