Provider Demographics
NPI:1477636041
Name:ELITE REHAB & FITNESS, LLC
Entity Type:Organization
Organization Name:ELITE REHAB & FITNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO- OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:740-550-0672
Mailing Address - Street 1:PO BOX 107
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:OH
Mailing Address - Zip Code:45638-0107
Mailing Address - Country:US
Mailing Address - Phone:740-532-0770
Mailing Address - Fax:740-532-0708
Practice Address - Street 1:202 PARK AVE
Practice Address - Street 2:SUITE A
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-1548
Practice Address - Country:US
Practice Address - Phone:740-532-0770
Practice Address - Fax:740-532-0708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy