MEDICARE: JOSEPH T ELLIOTT DPT

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
1	225100000X	Physical Therapist	1191758	TX

General Provider Information

NPI Number	:	1942691670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH T ELLIOTT DPT

Provider Business Mailing Address
First Line	:	414 W SUNSET RD
Second Line	:	SUITE 110
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-1756
Country	:	US
Telephone Number	:	210-828-7557
Fax Number	:	210-828-7756

Provider Business Practice Location Address
First Line	:	414 W SUNSET RD
Second Line	:	SUITE 110
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-1756
Country	:	US
Telephone Number	:	210-828-7557
Fax Number	:	210-828-7756

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2015
Last Update Date	:	02/17/2015

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Directions to “ JOSEPH T ELLIOTT DPT” Practice Location

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