Provider Demographics
NPI:1255195418
Name:ELEVATED STRENGTH REHAB
Entity type:Organization
Organization Name:ELEVATED STRENGTH REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:240-515-4760
Mailing Address - Street 1:23824 BENNETT CHASE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-5317
Mailing Address - Country:US
Mailing Address - Phone:240-515-4760
Mailing Address - Fax:
Practice Address - Street 1:220 GIRARD ST STE C
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-3489
Practice Address - Country:US
Practice Address - Phone:240-515-4760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy