Organization
ELITE PHYSICAL THERAPY AND SPORTS MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD BAISDEN PT (OWNER)
(765) 297-0975
Entity
Organization
Contact information
Practice address
823 PARK EAST BLVD STE B, LAFAYETTE, IN 47905-0811
(765) 297-0975
(765) 297-0974
Mailing address
823 PARK EAST BLVD STE B, LAFAYETTE, IN 47905-0811
(765) 297-0975
(765) 297-0974
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
08/04/2022
Last updated
11/14/2022
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