MEDICARE: ELITE THERAPY & PERFORMANCE PLLC

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	225X00000X	Occupational Therapist
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1922784958
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE THERAPY & PERFORMANCE PLLC

Provider Business Mailing Address
First Line	:	995 HARDY RD
Second Line	:
City	:	VINTON
State	:	VA
Zip	:	24179-3643
Country	:	US
Telephone Number	:	540-988-2808
Fax Number	:

Provider Business Practice Location Address
First Line	:	995 HARDY RD
Second Line	:
City	:	VINTON
State	:	VA
Zip	:	24179-3643
Country	:	US
Telephone Number	:	540-728-0986
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BRETT HALL
Credential	:	DPT
Telephone Number	:	540-728-0986

Provider Enumeration Date	:	06/26/2023
Last Update Date	:	02/23/2026

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