Provider Demographics
NPI:1801571682
Name:ELEVATE KIDS PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:ELEVATE KIDS PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:SCHUERMAN
Authorized Official - Last Name:LAUBACH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:405-205-3741
Mailing Address - Street 1:4528 BLACK HORSE RD
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-9614
Mailing Address - Country:US
Mailing Address - Phone:405-205-3741
Mailing Address - Fax:
Practice Address - Street 1:4528 BLACK HORSE RD
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-9614
Practice Address - Country:US
Practice Address - Phone:405-205-3741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-19
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty