Organization
ELITE PHYSICAL MEDICINE AND REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID SEGRAVES (MEMBER)
(513) 486-3744
Entity
Organization
Contact information
Practice address
401 W EADS PKWY STE 320, LAWRENCEBURG, IN 47025-1374
(812) 539-2900
Mailing address
401 W EADS PKWY STE 320, LAWRENCEBURG, IN 47025-1374
(812) 539-2900
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
06/26/2020
Last updated
01/27/2023
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