Provider Demographics
NPI:1104465343
Name:ELITE PHYSICAL THERAPY AND WELLNESS LLC
Entity type:Organization
Organization Name:ELITE PHYSICAL THERAPY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:EMILIO
Authorized Official - Middle Name:
Authorized Official - Last Name:GALIS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:412-997-6405
Mailing Address - Street 1:338 HELEN AVE
Mailing Address - Street 2:
Mailing Address - City:MONESSEN
Mailing Address - State:PA
Mailing Address - Zip Code:15062-2411
Mailing Address - Country:US
Mailing Address - Phone:412-997-6405
Mailing Address - Fax:
Practice Address - Street 1:638 ROSTRAVER RD STE 102
Practice Address - Street 2:
Practice Address - City:ROSTRAVER TWP
Practice Address - State:PA
Practice Address - Zip Code:15012-1967
Practice Address - Country:US
Practice Address - Phone:412-997-6405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-06
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy