Provider Demographics
NPI:1699037127
Name:ELLIOTT, EMILY RUTH (BS, LPTA)
Entity type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:RUTH
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:BS, LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:378 SCURLOCK RD
Mailing Address - Street 2:
Mailing Address - City:PATRIOT
Mailing Address - State:OH
Mailing Address - Zip Code:45658-9327
Mailing Address - Country:US
Mailing Address - Phone:740-339-9559
Mailing Address - Fax:
Practice Address - Street 1:86 COLUMBUS RD
Practice Address - Street 2:SUITE 203
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-1300
Practice Address - Country:US
Practice Address - Phone:740-249-4081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH08204225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant