Individual
SHANNA RUTH ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2055 KIMBALL AVE, SUITE 101, WATERLOO, IA 50702
(319) 272-2112
(319) 272-2107
Mailing address
2055 KIMBALL AVE, SUITE 101, WATERLOO, IA 50702
(319) 272-2112
(319) 272-2107
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R-10280
IA
Other
Enumeration date
06/08/2015
Last updated
06/08/2015
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