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Contact Information

ELITE HEALTHCARE PHYSICAL MEDICINE
307 ADAMSON SQ
CARROLLTON, GA30117-3213
 Phone: 770-214-9146
 Fax: 770-214-9166
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Family

363LF0000X 50 Nurse Practitioner
 

Rehabilitation

111NR0400X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for ELITE HEALTHCARE PHYSICAL MEDICINE

NPI # 1669736120
LBN Legal business name ELITE HEALTHCARE PHYSICAL MEDICINE
Authorized official RYAN WEBER - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/29/2012
Last updated 06/29/2012 - About 14 years ago
Identifiers
GA License # 052922
GA License # CHIR007565
GA License # RN148627
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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