Healthcare Provider Details

I. General information

NPI: 1861445173
Provider Name (Legal Business Name): ELITE PHYSICAL THERAPY AND REHABILITATION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 10/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1114 N MAIN ST
SHELBYVILLE TN
37160-2310
US

IV. Provider business mailing address

1114 N MAIN ST
SHELBYVILLE TN
37160-2310
US

V. Phone/Fax

Practice location:
  • Phone: 931-684-0027
  • Fax: 931-684-0112
Mailing address:
  • Phone: 931-684-0027
  • Fax: 931-684-0112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. JULIE ANNE SHOEMAKE
Title or Position: BUSINESS ADMINISTRATOR
Credential:
Phone: 931-684-0027