| Elite Sport & Spine Physical Therapy, Inc. | |
|
2 Mashburn St Ste 102, Hawkinsville, GA 31036-4961 | |
| (478) 292-7865 | |
| (478) 783-4466 |
| Full Name | Elite Sport & Spine Physical Therapy, Inc. |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 2 Mashburn St Ste 102, Hawkinsville, Georgia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518985282 | NPI | - | NPPES |
| 000754619B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Sport & Spine Physical Therapy, Inc. 2 Mashburn St, Hawkinsville, GA 31036-4961 Ph: (478) 292-7865 | Elite Sport & Spine Physical Therapy, Inc. 2 Mashburn St Ste 102, Hawkinsville, GA 31036-4961 Ph: (478) 292-7865 |
Kyle Thompson, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2 Mashburn St Ste 102, Hawkinsville, GA 31036 Phone: 478-783-4460 Fax: 478-783-4466 | |
Abigail Gilliam, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 2 Mashburn St, Hawkinsville, GA 31036 Phone: 478-783-4460 |