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General NPI Number Information
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NPI Number | 1548447410
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Entity Type | Organization
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Legal Business Name | ELITE PHYSICAL THERAPY & SPORTS PERFORMANCE
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Dates
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Enumeration Date | 01/23/2008
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Last Update Date | 06/24/2021
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Provider Practice Location Address
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Address Line | 4 OKATIE CENTER BLVD SOUTH SUITE 101 BLDG 6
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City | BLUFFTON
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State | SC
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Zip | 29909
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Country | US
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Telephone | 501-348-3776
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Fax |
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Provider Business Mailing Address
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Address Line | 4 OKATIE CENTER BLVD S STE 101
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City | OKATIE
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State | SC
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Zip | 29909-7530
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Country | US
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Telephone | 843-705-9480
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Fax | 843-705-9481
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Authorized Official
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Title or Position | OWNER
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Name | MR. WIL CRAPPS
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Credential | PT
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Telephone | 843-705-9480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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