Provider Demographics
NPI:1235324229
Name:ELLIOTT, CURTIS SR (LPTA)
Entity type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:
Last Name:ELLIOTT
Suffix:SR
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FRC 4101 RAEFORD RD UNIT 100B
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304
Mailing Address - Country:US
Mailing Address - Phone:910-570-3295
Mailing Address - Fax:
Practice Address - Street 1:4101 RAEFORD RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4114
Practice Address - Country:US
Practice Address - Phone:910-908-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA1912225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant