Provider Demographics
NPI:1427945682
Name:ELEVATE PHYSICAL THERAPY AND SPORTS REHAB
Entity type:Organization
Organization Name:ELEVATE PHYSICAL THERAPY AND SPORTS REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KURTIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCINTIRE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:218-234-1597
Mailing Address - Street 1:1085 DELSEA DR
Mailing Address - Street 2:
Mailing Address - City:WESTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08093-1644
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1085 DELSEA DR
Practice Address - Street 2:
Practice Address - City:WESTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08093-1644
Practice Address - Country:US
Practice Address - Phone:586-281-1363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy