Individual
ELLIOTT BRENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5350 MADISON AVE, SACRAMENTO, CA 95841-3169
(916) 677-0008
Mailing address
5350 MADISON AVE, SACRAMENTO, CA 95841-3169
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT14583
CA
Other
Enumeration date
08/05/2018
Last updated
08/05/2018
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