Organization
ELITE PT
Active
Organization
ELITE PT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE WEBER (PHYSICAL THERAPIST)
(701) 260-2046
Entity
Organization
Contact information
Practice address
1674 15TH ST W STE 1, DICKINSON, ND 58601-2811
(701) 260-2046
Mailing address
642 17TH AVE E, DICKINSON, ND 58601-3742
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
06/23/2017
Last updated
06/23/2017
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