Provider Demographics
NPI:1770263873
Name:ELEVATED PELVIC HEALTH AND WELLNESS PLLC
Entity type:Organization
Organization Name:ELEVATED PELVIC HEALTH AND WELLNESS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:NICE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:509-508-1131
Mailing Address - Street 1:1516 W 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-4022
Mailing Address - Country:US
Mailing Address - Phone:801-608-6877
Mailing Address - Fax:
Practice Address - Street 1:501 S BERNARD ST STE 308
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2511
Practice Address - Country:US
Practice Address - Phone:509-508-1131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2024-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy