MEDICARE: DR. ELINA GORELKIN PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5501015302	MI

General Provider Information

NPI Number	:	1033481510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELINA GORELKIN PT, DPT

Provider Business Mailing Address
First Line	:	799 N HOLBROOK ST
Second Line	:
City	:	PLYMOUTH
State	:	MI
Zip	:	48170-1407
Country	:	US
Telephone Number	:	248-595-1500
Fax Number	:

Provider Business Practice Location Address
First Line	:	5436 KINGSFIELD DR
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-1488
Country	:	US
Telephone Number	:	248-595-1500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2012
Last Update Date	:	11/07/2020

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