Provider Demographics
NPI:1922454438
Name:ELEVATE HEALTH, LLC
Entity Type:Organization
Organization Name:ELEVATE HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRONWYN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BACON
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:406-219-3631
Mailing Address - Street 1:801 W MAIN ST
Mailing Address - Street 2:#1C
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3336
Mailing Address - Country:US
Mailing Address - Phone:406-219-3631
Mailing Address - Fax:206-760-1809
Practice Address - Street 1:801 W MAIN ST
Practice Address - Street 2:#1C
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3336
Practice Address - Country:US
Practice Address - Phone:406-219-3631
Practice Address - Fax:206-760-1809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-13
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT822MT175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty