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NPI Code Detail

MEDICARE: MS. JULIE L. ELLIOTT

MEDICARE: MS. JULIE L. ELLIOTT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175F00000XNaturopath

General Provider Information

NPI Number : 1558431221
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JULIE L. ELLIOTT
Provider Business Mailing Address
First Line : 634 S ROOSEVELT ST
Second Line : STE 3
City : ABERDEEN
State : SD
Zip : 57401-6593
Country : US
Telephone Number : 605-725-5502
Fax Number : 605-725-5501
Provider Business Practice Location Address
First Line : 634 S ROOSEVELT ST
Second Line : STE 3
City : ABERDEEN
State : SD
Zip : 57401-6593
Country : US
Telephone Number : 605-725-5502
Fax Number : 605-725-5501
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2006
Last Update Date : 07/08/2007

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