Provider Demographics
NPI:1215150933
Name:ELITE PHYSICAL THERAPY
Entity type:Organization
Organization Name:ELITE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:MCCAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:410-799-0818
Mailing Address - Street 1:8165 CYPRUS CEDAR LN STE 205
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-5565
Mailing Address - Country:US
Mailing Address - Phone:410-799-0818
Mailing Address - Fax:410-799-2653
Practice Address - Street 1:6801 DOUGLAS LEGUM DR STE B
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6273
Practice Address - Country:US
Practice Address - Phone:410-799-0818
Practice Address - Fax:410-799-2653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
981LMedicare ID - Type Unspecified