MEDICARE: ELITE PHYSICAL THERAPY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist
2	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1689338774
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	6447 GLENDALE DR
Second Line	:
City	:	WHITE LAKE
State	:	MI
Zip	:	48383-3370
Country	:	US
Telephone Number	:	586-604-7233
Fax Number	:

Provider Business Practice Location Address
First Line	:	6785 23 MILE RD
Second Line	:
City	:	SHELBY TOWNSHIP
State	:	MI
Zip	:	48316-4414
Country	:	US
Telephone Number	:	586-788-7107
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PHYSICAL THERAPIST
Name	:	RACHEL A VULETICH
Credential	:	PT, DPT, OMPT
Telephone Number	:	586-604-7233

Provider Enumeration Date	:	10/26/2021
Last Update Date	:	06/26/2026

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