Provider Demographics
NPI:1053705996
Name:ELKINS, JOHN
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:ELKINS
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 1:4041 REID RD
Mailing Address - Street 2:
Mailing Address - City:TOBACCOVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27050-9527
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4041 REID RD
Practice Address - Street 2:
Practice Address - City:TOBACCOVILLE
Practice Address - State:NC
Practice Address - Zip Code:27050-9527
Practice Address - Country:US
Practice Address - Phone:336-486-5292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-27
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA4402225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant