Healthcare Provider Details

I. General information

NPI: 1922784958
Provider Name (Legal Business Name): ELITE THERAPY & PERFORMANCE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

995 HARDY RD
VINTON VA
24179-3643
US

IV. Provider business mailing address

995 HARDY RD
VINTON VA
24179-3643
US

V. Phone/Fax

Practice location:
  • Phone: 540-728-0986
  • Fax:
Mailing address:
  • Phone: 540-988-2808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: BRETT HALL
Title or Position: OWNER
Credential: DPT
Phone: 540-728-0986