Individual
DAKOTA RILEY ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
10100 ROAD 2442, UNION, MS 39365-4010
(601) 575-2025
Mailing address
10100 ROAD 2442, UNION, MS 39365-4010
(601) 575-2025
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT8457
TX
Other
Enumeration date
09/15/2021
Last updated
09/15/2021
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