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Organization

STEPHENVILLE SPORTS REHAB & PHYSICAL THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CHAD ALLEN ELMS PT (OWNER)
(817) 341-3600
Entity
Organization

Contact information

Practice address
141 COLLEGE PARK DR, WEATHERFORD, TX 76086-5653
(817) 341-3600
(817) 599-8181
Mailing address
141 COLLEGE PARK DR, WEATHERFORD, TX 76086-5653
(817) 341-3600
(817) 599-8181

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
651220000
TX
208100000X
Physical Medicine & Rehabilitation Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0040JB
BLUE CROSS BLUE SHIELD
TX
05
108013702
TX
01
278208
SCOTT & WHITE HEALTH PLAN
01
622548400
DEPT OF LOABOR
TX
01
9767023
CIGNA
Enumeration date
09/29/2006
Last updated
11/08/2024
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