Provider Demographics
NPI:1578182457
Name:CELTIC ENTERPRIZE INC
Entity Type:Organization
Organization Name:CELTIC ENTERPRIZE INC
Other - Org Name:PHYSIOREHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDRUS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:352-234-5777
Mailing Address - Street 1:119 BAKERS ACRES DR
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:FL
Mailing Address - Zip Code:32640-4159
Mailing Address - Country:US
Mailing Address - Phone:352-234-5456
Mailing Address - Fax:877-515-5940
Practice Address - Street 1:119 BAKERS ACRES DR
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:FL
Practice Address - Zip Code:32640-4159
Practice Address - Country:US
Practice Address - Phone:352-234-5456
Practice Address - Fax:877-515-5940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-10
Last Update Date:2020-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty