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Organization
1ST ADVANTAGE PHYSICAL THERAPY PC
Active
Organization
1ST ADVANTAGE PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN ELO PT (PRESIDENT)
(219) 663-3554
Entity
Organization
Contact information
Practice address
1516 N MAIN ST, CROWN POINT, IN 46307-2332
(219) 226-1500
(219) 226-0500
Mailing address
1516 N MAIN ST, CROWN POINT, IN 46307-2332
(219) 226-1500
(219) 226-0500
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
05005012A
IN
Other
Enumeration date
12/07/2007
Last updated
01/22/2008
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