Individual
KIM MARIE ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 W 9TH NORTH ST, SUMMERVILLE, SC 29483-6721
(843) 879-0922
Mailing address
201 W 9TH NORTH ST, SUMMERVILLE, SC 29483-6721
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2720
SC
Other
Enumeration date
02/01/2019
Last updated
02/01/2019
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