Provider Demographics
NPI:1467037804
Name:ELEVATE THERAPY LLC
Entity Type:Organization
Organization Name:ELEVATE THERAPY LLC
Other - Org Name:ELEVATE SPORTS ENHANCEMENT AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:MS
Authorized Official - First Name:KARLI
Authorized Official - Middle Name:SU
Authorized Official - Last Name:RIKLI
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:719-375-5314
Mailing Address - Street 1:630 SOUTHPOINTE CT STE 105
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3800
Mailing Address - Country:US
Mailing Address - Phone:719-375-5314
Mailing Address - Fax:719-418-2833
Practice Address - Street 1:630 SOUTHPOINTE CT STE 105
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3800
Practice Address - Country:US
Practice Address - Phone:719-375-5314
Practice Address - Fax:719-418-2833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty