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General NPI Number Information
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NPI Number | 1154666154
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Entity Type | Organization
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Legal Business Name | ELITE PHYSICAL THERAPY
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Dates
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Enumeration Date | 12/01/2012
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Last Update Date | 02/04/2013
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Provider Practice Location Address
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Address Line | 37624 SE FURY ST SUITE C201
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City | SNOQUALMIE
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State | WA
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Zip | 98065-9680
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Country | US
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Telephone | 630-730-5693
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Fax |
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Provider Business Mailing Address
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Address Line | 37624 SE FURY ST STE C201
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City | SNOQUALMIE
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State | WA
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Zip | 98065-9680
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Country | US
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Telephone | 425-941-9756
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | SHILPA PATEL
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Credential | DPT
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Telephone | 630-730-5693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 00010762
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 00009462
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 0010762
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License Number State | WA
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