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General NPI Number Information
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NPI Number | 1427411362
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Entity Type | Organization
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Legal Business Name | ELEVATION HEALTH AND PERFORMANCE PLLC
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Dates
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Enumeration Date | 03/29/2016
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Last Update Date | 01/11/2023
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Provider Practice Location Address
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Address Line | 3000 CENTER GREEN DR STE 130
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City | BOULDER
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State | CO
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Zip | 80301-2364
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Country | US
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Telephone | 303-444-5105
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 CENTER GREEN DR STE 130
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City | BOULDER
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State | CO
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Zip | 80301-2364
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Country | US
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Telephone | 303-444-5105
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN, MEMBER
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Name | ALYX BROWN
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Credential | DC
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Telephone | 503-522-8818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 0007297
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License Number State | CO
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