Provider Demographics
NPI:1467466821
Name:ELLIOT, COLIN JC (MCSP, RPT, BSPT)
Entity type:Individual
Prefix:
First Name:COLIN
Middle Name:JC
Last Name:ELLIOT
Suffix:
Gender:M
Credentials:MCSP, RPT, BSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14535 JOHN MARSHALL HWY STE 203
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-4025
Mailing Address - Country:US
Mailing Address - Phone:703-753-0261
Mailing Address - Fax:703-743-2967
Practice Address - Street 1:14535 JOHN MARSHALL HWY STE 203
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-4025
Practice Address - Country:US
Practice Address - Phone:703-753-0261
Practice Address - Fax:703-743-2967
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305004811225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist