Individual
JERIN D ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
705 HIDDENLAKE CT, BROWNS SUMMIT, NC 27214-7000
(336) 501-0474
Mailing address
705 HIDDENLAKE CT, BROWNS SUMMIT, NC 27214-7000
(336) 501-0474
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/06/2010
Last updated
01/06/2010
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