Healthcare Provider Details

I. General information

NPI: 1609380922
Provider Name (Legal Business Name): ELEVATION MEDICAL CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2017
Last Update Date: 11/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2349 GLENARM PLACE
DENVER CO
80205
US

IV. Provider business mailing address

757 E. 20TH AVE SUITE 370 #831
DENVER CO
80205
US

V. Phone/Fax

Practice location:
  • Phone: 720-372-6751
  • Fax: 303-362-6615
Mailing address:
  • Phone: 720-372-6751
  • Fax: 303-362-6615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. THOMAS NILES RUBINSON
Title or Position: MANAGER/CO-OWNER
Credential: CNIM
Phone: 719-930-1073