Provider Demographics
NPI:1558064220
Name:ELEVATE WELLNESS, PLLC
Entity Type:Organization
Organization Name:ELEVATE WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:REESE
Authorized Official - Last Name:CORWIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:406-253-2328
Mailing Address - Street 1:PO BOX 5574
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-5574
Mailing Address - Country:US
Mailing Address - Phone:406-253-8924
Mailing Address - Fax:
Practice Address - Street 1:121 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2304
Practice Address - Country:US
Practice Address - Phone:406-253-2328
Practice Address - Fax:406-794-0469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-22
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy