Provider Demographics
NPI:1225848872
Name:ELITE MOVEMENT WS LLC
Entity type:Organization
Organization Name:ELITE MOVEMENT WS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:770-891-6175
Mailing Address - Street 1:1315 LEHEIGH CT
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-5111
Mailing Address - Country:US
Mailing Address - Phone:770-891-6175
Mailing Address - Fax:
Practice Address - Street 1:225 E 5TH ST
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-4142
Practice Address - Country:US
Practice Address - Phone:336-462-9196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy