Individual
MR. JUSTIN MICHAEL ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
1149 W MONROE RD, ST. LOUIS, MI 48880
(989) 681-3852
Mailing address
4621 ASHLAND DR, SAGINAW, MI 48638
(989) 482-6869
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009383
MI
Other
Enumeration date
03/16/2016
Last updated
03/16/2016
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