Provider Demographics
NPI:1114798253
Name:UPLIFT PELVIC HEALTH AND PERFORMANCE LLC
Entity Type:Organization
Organization Name:UPLIFT PELVIC HEALTH AND PERFORMANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:LAUREN LEE
Authorized Official - Last Name:DAVENPORT
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:919-222-5825
Mailing Address - Street 1:16501 NORTHCROSS DR
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-5000
Mailing Address - Country:US
Mailing Address - Phone:704-251-5141
Mailing Address - Fax:
Practice Address - Street 1:16501 NORTHCROSS DR
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-5000
Practice Address - Country:US
Practice Address - Phone:704-251-5141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UPLIFT PELVIC HEALTH AND PERFORMANCE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy