Provider Demographics
NPI:1942033659
Name:ELLIOTT, ANDREW THOMAS
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:THOMAS
Last Name:ELLIOTT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:WEST UNION
Mailing Address - State:OH
Mailing Address - Zip Code:45693-1058
Mailing Address - Country:US
Mailing Address - Phone:937-798-0292
Mailing Address - Fax:
Practice Address - Street 1:421 HICKORY ST
Practice Address - Street 2:
Practice Address - City:WEST UNION
Practice Address - State:OH
Practice Address - Zip Code:45693-1058
Practice Address - Country:US
Practice Address - Phone:937-798-0292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide