Provider Demographics
NPI:1326672106
Name:ELEVATION HEALTH DEBARY, LLC
Entity Type:Organization
Organization Name:ELEVATION HEALTH DEBARY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:386-277-1550
Mailing Address - Street 1:881 S CHARLES RICHARD BEALL BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:DEBARY
Mailing Address - State:FL
Mailing Address - Zip Code:32713-9738
Mailing Address - Country:US
Mailing Address - Phone:386-277-1550
Mailing Address - Fax:
Practice Address - Street 1:881 S CHARLES RICHARD BEALL BLVD STE 106
Practice Address - Street 2:
Practice Address - City:DEBARY
Practice Address - State:FL
Practice Address - Zip Code:32713-9738
Practice Address - Country:US
Practice Address - Phone:386-277-1550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty