Provider Demographics
NPI:1538709167
Name:ELITE TOUCH PHYSICAL THERAPY
Entity type:Organization
Organization Name:ELITE TOUCH PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:TARNER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:814-765-2351
Mailing Address - Street 1:305 MEYERS CIRCLE
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-1020
Mailing Address - Country:US
Mailing Address - Phone:814-765-2351
Mailing Address - Fax:814-765-1095
Practice Address - Street 1:712 RIVER ROAD
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-1020
Practice Address - Country:US
Practice Address - Phone:814-765-2351
Practice Address - Fax:814-765-1095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-12
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103765215-0001Medicaid