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Organization

1ST ADVANTAGE PHYSICAL THERAPY PC

Active
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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

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000363591
ANTHEM
IN
01
P00374932
RAILROAD MEDICARE
IN
Enumeration date
12/07/2007
Last updated
01/22/2008
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If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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