Provider Demographics
NPI:1821122326
Name:ELKO REHABILITATION INC
Entity Type:Organization
Organization Name:ELKO REHABILITATION INC
Other - Org Name:ELKO PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:CASSADY
Authorized Official - Last Name:GUYER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:775-738-9600
Mailing Address - Street 1:2219 N 5TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-2458
Mailing Address - Country:US
Mailing Address - Phone:775-738-9600
Mailing Address - Fax:775-738-9638
Practice Address - Street 1:2219 N 5TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-2458
Practice Address - Country:US
Practice Address - Phone:775-738-9600
Practice Address - Fax:775-738-9638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV136261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVRPT136Medicare PIN