# ELITE SPORTS PHYSICAL THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649590035
- **Authorized official:** MS. SHARON WENTWORTH DPT, MSPT (OWNER)
- **Authorized official phone:** (732) 544-0011

## Contact information

- **Practice address:** 1540 W PARK AVE, STE 4, TINTON FALLS, NJ 07712-3191
- **Practice address phone:** (732) 544-0011
- **Practice address fax:** (732) 544-1115
- **Mailing address:** 1540 W PARK AVE, STE 4, TINTON FALLS, NJ 07712-3191
- **Mailing address phone:** (732) 544-0011
- **Mailing address fax:** (732) 544-1115

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | — | NULL | — |
| 171100000X | Acupuncturist | — | — | — |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 06/08/2010
- **Last updated:** 03/13/2017