Provider Demographics
NPI:1396552907
Name:ENHANCE PERFORMANCE PHYSICAL THERAPY
Entity type:Organization
Organization Name:ENHANCE PERFORMANCE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LEAD PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTKES
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:732-570-5037
Mailing Address - Street 1:515 WOODMERE AVE
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-5635
Mailing Address - Country:US
Mailing Address - Phone:732-570-5037
Mailing Address - Fax:
Practice Address - Street 1:3407 ROSE AVE
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-3968
Practice Address - Country:US
Practice Address - Phone:732-570-5037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty