Provider Demographics
NPI:1316795974
Name:ELITE SPORTS TRAINING
Entity type:Organization
Organization Name:ELITE SPORTS TRAINING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:HENSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:502-558-0149
Mailing Address - Street 1:2561 SUN SEEKER CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2980
Mailing Address - Country:US
Mailing Address - Phone:502-558-0149
Mailing Address - Fax:
Practice Address - Street 1:3101 CLAYS MILL RD APT 203
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2781
Practice Address - Country:US
Practice Address - Phone:502-558-0149
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty