Elite Physical Therapy, Inc.
Organization Active NPI Physical Therapist · Commerce, GA
NPI 1164594859 · NPPES record last updated Mar 4, 2009
Key facts
- NPI
- 1164594859
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT004868 (GA)
- Legal business name
- ELITE PHYSICAL THERAPY, INC.
- Practice address
- 205 Mercer PL
Homer Road
Commerce, GA 30529-1564 - Phone
- (706) 335-3816
- Fax
- (706) 335-3819
- NPI assigned
- Nov 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Brian Eugene Vandiver, PT
- Title
- PT Co Owner President
- Phone
- (706) 335-3816
Practitioners 2
-
David Henry Pate, MSPT, MS, CSCS
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | PT004868 | GA | Yes |
Addresses
Primary practice location
205 Mercer PL
Homer Road
Commerce, GA 30529-1564
Mailing address
205 Mercer PL
Homer Road
Commerce, GA 30529-1564
Phone (706) 335-3816
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00981439A | Medicaid | GA |
Other providers in Commerce, GA
- Roy E Doss
- Shelia Doss
- Charles Seidel Dwozan
- Michael R. Eberhardt
- Edmunds Programs for Human Services Incorporated
- Tabitha Evans
- Evernorth Direct Health LLC
- Every Smile Family Dentistry
- Family First Care of Commerce, LLC
- Family Foot Care Center
All providers in Commerce, GA · Physical Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.