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General NPI Number Information
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NPI Number | 1013696814
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Entity Type | Organization
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Legal Business Name | ELEVATE MEDICAL, LLC
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Dates
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Enumeration Date | 07/18/2023
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Last Update Date | 08/30/2024
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Provider Practice Location Address
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Address Line | 1491 HARTFORD HWY
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City | DOTHAN
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State | AL
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Zip | 36301-3349
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Country | US
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Telephone | 334-673-1488
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Fax | 334-673-8496
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Provider Business Mailing Address
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Address Line | 1491 HARTFORD HWY
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City | DOTHAN
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State | AL
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Zip | 36301-3349
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Country | US
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Telephone | 334-673-1488
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Fax | 334-673-8496
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Authorized Official
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Title or Position | CASE MANAGER
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Name | ASHLEY ANDERSON
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Credential |
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Telephone | 334-673-1488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number |
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License Number State |
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