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General NPI Number Information
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NPI Number | 1255195418
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Entity Type | Organization
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Legal Business Name | ELEVATED STRENGTH REHAB
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Dates
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Enumeration Date | 02/08/2024
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Last Update Date | 02/08/2024
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Provider Practice Location Address
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Address Line | 220 GIRARD ST STE C
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City | GAITHERSBURG
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State | MD
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Zip | 20877-3489
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Country | US
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Telephone | 240-515-4760
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Fax |
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Provider Business Mailing Address
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Address Line | 23824 BENNETT CHASE DR
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City | CLARKSBURG
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State | MD
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Zip | 20871-5317
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Country | US
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Telephone | 240-515-4760
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JONATHAN KIM
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Credential | DPT
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Telephone | 240-515-4760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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