Provider Demographics
NPI:1710595962
Name:ELEVATE HEALTH CLINICS LLC
Entity Type:Organization
Organization Name:ELEVATE HEALTH CLINICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:AUTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-737-8806
Mailing Address - Street 1:2127 E BASELINE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1537
Mailing Address - Country:US
Mailing Address - Phone:480-737-8806
Mailing Address - Fax:
Practice Address - Street 1:2127 E BASELINE RD STE 101
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1537
Practice Address - Country:US
Practice Address - Phone:480-737-8806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty