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General NPI Number Information
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NPI Number | 1356207583
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Entity Type | Organization
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Legal Business Name | ELEVATE MUSCLE & JOINT
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Dates
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Enumeration Date | 12/31/2025
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 60 W SUNBRIDGE DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-1822
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Country | US
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Telephone | 479-234-0463
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Fax |
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Provider Business Mailing Address
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Address Line | 60 W SUNBRIDGE DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-1822
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Country | US
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Telephone | 479-234-0463
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Fax |
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Authorized Official
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Title or Position | OWNER, CHIROPRACTIC DR
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Name | DR. KODY L CHASTAIN
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Credential | DC
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Telephone | 479-234-0463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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