Healthcare Provider Details

I. General information

NPI: 1427411362
Provider Name (Legal Business Name): ELEVATION HEALTH AND PERFORMANCE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2016
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 CENTER GREEN DR STE 130
BOULDER CO
80301-2364
US

IV. Provider business mailing address

3000 CENTER GREEN DR STE 130
BOULDER CO
80301-2364
US

V. Phone/Fax

Practice location:
  • Phone: 303-444-5105
  • Fax:
Mailing address:
  • Phone: 303-444-5105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number0007297
License Number StateCO

VIII. Authorized Official

Name: ALYX BROWN
Title or Position: CHIROPRACTIC PHYSICIAN, MEMBER
Credential: DC
Phone: 503-522-8818