Individual
TYLER ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
QMHS
Contact information
Practice address
11 GRAHAM DR, ATHENS, OH 45701-1430
(800) 321-8293
Mailing address
PO BOX 1595, COLUMBUS, OH 43216-1595
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
06/18/2018
Last updated
02/06/2020
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