Provider Demographics
NPI:1063948479
Name:ELLIOTT, VAL H (COTA/L)
Entity type:Individual
Prefix:MR
First Name:VAL
Middle Name:H
Last Name:ELLIOTT
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 COLLEGE AVE STE A213
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2781
Mailing Address - Country:US
Mailing Address - Phone:785-587-1825
Mailing Address - Fax:785-587-1828
Practice Address - Street 1:1133 COLLEGE AVE STE A213
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2781
Practice Address - Country:US
Practice Address - Phone:785-587-1825
Practice Address - Fax:785-587-1828
Is Sole Proprietor?:No
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS18-01011224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant