Provider Demographics
NPI:1215424395
Name:ELITE MANUAL THERAPY
Entity type:Organization
Organization Name:ELITE MANUAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:484-509-0507
Mailing Address - Street 1:1006 OWLS NEST DR
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-3826
Mailing Address - Country:US
Mailing Address - Phone:484-509-0507
Mailing Address - Fax:
Practice Address - Street 1:1006 OWLS NEST DR
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-3826
Practice Address - Country:US
Practice Address - Phone:484-509-0507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-15
Last Update Date:2018-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADAPT002518261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy