Provider Demographics
NPI:1043847593
Name:ELEVATION CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:ELEVATION CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAKOB
Authorized Official - Middle Name:
Authorized Official - Last Name:SLATER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:931-444-1236
Mailing Address - Street 1:1825 MADISON ST STE D
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-6589
Mailing Address - Country:US
Mailing Address - Phone:931-444-1236
Mailing Address - Fax:
Practice Address - Street 1:1825 MADISON ST STE D
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-6589
Practice Address - Country:US
Practice Address - Phone:931-444-1236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-25
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty