Individual
MS. CYNTHIA MARIE ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
40403 FORMAN RD, POLSON, MT 59860-8366
(406) 883-2223
(406) 883-2223
Mailing address
40403 FORMAN RD, POLSON, MT 59860-8366
(406) 883-2223
(406) 883-2223
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
718
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
342482
—
MT
01
—
661110
BCBS PROVIDER NUMBER
MT
Enumeration date
11/12/2006
Last updated
07/09/2007
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