Individual
ELIJAH ST JOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
201 PALOMA DR, TEMPLE, TX 76502-7650
(936) 204-0522
Mailing address
6512 BROOKS DR, TEMPLE, TX 76502-6300
(936) 204-0522
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2098353
TX
Other
Enumeration date
07/26/2018
Last updated
02/20/2020
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