Provider Demographics
NPI:1710426697
Name:CRK, LLC.
Entity Type:Organization
Organization Name:CRK, LLC.
Other - Org Name:ELITE CARE PHYSICAL THERAPY AT CHESAPEAKE BEACH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PART OWNER/ PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSALEA
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, ATC
Authorized Official - Phone:240-299-4686
Mailing Address - Street 1:P.O. BOX 978
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE BEACH
Mailing Address - State:MD
Mailing Address - Zip Code:20732
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8501 BAYSIDE ROAD
Practice Address - Street 2:SUITE C 4
Practice Address - City:CHESAPEAKE BEACH
Practice Address - State:MD
Practice Address - Zip Code:20732-8501
Practice Address - Country:US
Practice Address - Phone:240-299-4686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty