Provider Demographics
NPI:1902177678
Name:ELITE THERAPY SOLUTIONS, LLC
Entity Type:Organization
Organization Name:ELITE THERAPY SOLUTIONS, LLC
Other - Org Name:PRECISION REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:L
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:337-501-6264
Mailing Address - Street 1:3524 KALISTE SALOOM RD
Mailing Address - Street 2:BLDG. 2, STE. 205
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-7638
Mailing Address - Country:US
Mailing Address - Phone:337-993-2766
Mailing Address - Fax:337-993-2764
Practice Address - Street 1:3524 KALISTE SALOOM RD
Practice Address - Street 2:BLDG. 2, STE. 205
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7638
Practice Address - Country:US
Practice Address - Phone:337-993-2766
Practice Address - Fax:337-993-2764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-26
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA08138R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty