# 1ST ADVANTAGE PHYSICAL THERAPY PC

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

## Provider details

- **NPI number:** 1962685388
- **Authorized official:** KEVIN ELO PT (PRESIDENT)
- **Authorized official phone:** (219) 663-3554

## Contact information

- **Practice address:** 1516 N MAIN ST, CROWN POINT, IN 46307-2332
- **Practice address phone:** (219) 226-1500
- **Practice address fax:** (219) 226-0500
- **Mailing address:** 1516 N MAIN ST, CROWN POINT, IN 46307-2332
- **Mailing address phone:** (219) 226-1500
- **Mailing address fax:** (219) 226-0500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 05005012A | IN | Yes |

## Other

- **Enumeration date:** 12/07/2007
- **Last updated:** 01/22/2008