Individual
LEATRICE ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 W JEFFERSON ST, SPRINGFIELD, OH 45506-1224
(937) 505-2855
(937) 505-2972
Mailing address
1500 W JEFFERSON ST, SPRINGFIELD, OH 45506-1224
(937) 505-2855
(937) 505-2972
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OH1257649
OH
Other
Enumeration date
10/08/2014
Last updated
10/08/2014
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