| Organization Name: | ELITE PERFORMANCE PHYSICAL THERAPY LLC |
| NPI Number: | 1073890570 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HEATHER GAWELEK (OFFICE MANAGER) |
| Mailing Address: | 710 Leona St Elyria |
| State: | OH US |
| Postal Code: | 440352349 |
| Phone Number: | 4403240092 |
| Fax Number: | 4403240093 |
| NPI Enumeration Date: | 11/11/2011 |
| NPI Last Update Date: | 11/11/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 9338 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |