Organization
ELITE PERFORMANCE AND REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM FULCHER JR. (PARTNER)
(601) 636-0097
Entity
Organization
Contact information
Practice address
1901 A MISSION 66, VICKSBURG, MS 39180
(601) 636-0097
Mailing address
1901 A MISSION 66, VICKSBURG, MS 39180
(601) 636-0097
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
01/12/2017
Last updated
07/18/2022
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