Provider Demographics
NPI:1508918483
Name:ELITE PT, LLC
Entity Type:Organization
Organization Name:ELITE PT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:KNARR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:302-381-8348
Mailing Address - Street 1:23924 SUNNY COVE CT
Mailing Address - Street 2:VILLAGES AT HERRING CREEK
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-5695
Mailing Address - Country:US
Mailing Address - Phone:302-947-9822
Mailing Address - Fax:
Practice Address - Street 1:2101 DULANEY VALLEY RD
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-2819
Practice Address - Country:US
Practice Address - Phone:443-901-1938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD860LMedicare ID - Type UnspecifiedPHYSICAL THERAPIST