Individual
MRS. AUDREY NISSEN ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.P.T.
Contact information
Practice address
1072 LOS OSOS VALLEY RD, LOS OSOS, CA 93402-3237
(805) 528-2590
Mailing address
1678 PARTRIDGE DR, SAN LUIS OBISPO, CA 93405-6318
(805) 235-5054
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
23891
CA
Other
Enumeration date
09/21/2006
Last updated
07/08/2007
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