| Doctor Name: | DR. KAMAL A. ELLIOT |
| NPI Number: | 1639139223 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | AU.D. |
| License Number: | AY1669 |
| Business Practice Address: | 226 Willow Valley Lakes Dr Suite D Willow Street, PA - 175849665 |
| Business Phone Number: | 7174642144 |
| Business Fax Number: | 7174644255 |
| Mailing Address: | 1555 Highlands Dr, Suite 101 LITITZ |
| State: | PA |
| Postal Code: | 175432800 |
| Phone Number: | 7176274327 |
| Fax Number: | 7176272690 |
| NPI Enumeration Date: | 03/27/2006 |
| NPI Last Update Date: | 10/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | AY1669 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |