MEDICARE: EELIO, 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	225X00000X	Occupational Therapist
3	235Z00000X	Speech-Language Pathologist	8692	NC

General Provider Information

NPI Number	:	1891087268
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EELIO, LLC

Provider Business Mailing Address
First Line	:	2166 GOLD HILL RD
Second Line	:	SUITE B
City	:	FORT MILL
State	:	SC
Zip	:	29708-9351
Country	:	US
Telephone Number	:	803-802-5508
Fax Number	:	803-802-5528

Provider Business Practice Location Address
First Line	:	3227 LUKE CROSSING DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-3357
Country	:	US
Telephone Number	:	626-399-5767
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. ALEXIA GALAKATOS
Credential	:	MA, CCC-SLP
Telephone Number	:	626-399-5767

Provider Enumeration Date	:	05/04/2011
Last Update Date	:	05/04/2011

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Directions to “EELIO, LLC ” Practice Location

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