Organization
ELITE PHYSICAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID SEGRAVES (CEO)
(859) 544-2421
Entity
Organization
Contact information
Practice address
2091 N BEND RD STE 100, HEBRON, KY 41048-9122
(859) 544-2421
Mailing address
2091 N BEND RD, HEBRON, KY 41048-9691
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
04/21/2020
Last updated
04/04/2023
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