Healthcare Provider Details

I. General information

NPI: 1467037804
Provider Name (Legal Business Name): ELEVATE THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2021
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 SOUTHPOINTE CT STE 105
COLORADO SPRINGS CO
80906-3800
US

IV. Provider business mailing address

630 SOUTHPOINTE CT STE 105
COLORADO SPRINGS CO
80906-3800
US

V. Phone/Fax

Practice location:
  • Phone: 719-375-5314
  • Fax: 719-418-2833
Mailing address:
  • Phone: 719-375-5314
  • Fax: 719-418-2833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name: MS. KARLI SU RIKLI
Title or Position: DIRECTOR OF PHYSICAL THERAPY
Credential: MSPT
Phone: 719-375-5314