Provider Demographics
NPI:1285413724
Name:ELITE MOVEMENT SPECIALISTS LLC
Entity type:Organization
Organization Name:ELITE MOVEMENT SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPISTS
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BEAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:561-891-1795
Mailing Address - Street 1:4524 FORSYTH RD STE 104
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-4546
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:478-292-2117
Practice Address - Street 1:4524 FORSYTH RD STE 104
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-4546
Practice Address - Country:US
Practice Address - Phone:561-891-1795
Practice Address - Fax:478-292-2117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty