Provider Demographics
NPI:1376620914
Name:ELITE PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:ELITE PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDOWALL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:303-489-7893
Mailing Address - Street 1:11020 S PIKES PEAK DR STE 110
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-7413
Mailing Address - Country:US
Mailing Address - Phone:303-841-2524
Mailing Address - Fax:303-840-1319
Practice Address - Street 1:11020 S PIKES PEAK DR STE 110
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-7413
Practice Address - Country:US
Practice Address - Phone:303-841-2524
Practice Address - Fax:303-840-1319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36062251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO803192Medicare PIN