Healthcare Provider Details

I. General information

NPI: 1982073854
Provider Name (Legal Business Name): ELK REGIONAL PROFESSIONAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2015
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 N FRALEY ST STE 1
KANE PA
16735-1183
US

IV. Provider business mailing address

763 JOHNSONBURG RD
SAINT MARYS PA
15857-3400
US

V. Phone/Fax

Practice location:
  • Phone: 814-837-8955
  • Fax: 814-837-6592
Mailing address:
  • Phone: 814-375-4200
  • Fax: 814-375-4232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRIAN S KLINE
Title or Position: VP FISCAL AFFAIRS
Credential:
Phone: 814-375-6377