Organization
ELITE PERFORMANCE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAMBRIA NELSON (CEO)
(901) 607-8254
Entity
Organization
Contact information
Practice address
1081 BERRY ST, GRENADA, MS 38901-4228
(901) 607-8254
Mailing address
1081 BERRY ST, GRENADA, MS 38901-4228
(901) 607-8254
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
04/05/2022
Last updated
10/28/2022
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