| Organization Name: | ELK REGIONAL PROFESSIONAL GROUP INC |
| NPI Number: | 1972973246 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROSE M CAMPBELL (BOARD MEMBER) |
| Mailing Address: | 111 Cobb St Johnsonburg |
| State: | PA US |
| Postal Code: | 158451209 |
| Phone Number: | 8149655279 |
| Fax Number: | 8149654251 |
| NPI Enumeration Date: | 09/30/2015 |
| NPI Last Update Date: | 09/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |