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General NPI Number Information
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NPI Number | 1568252195
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Entity Type | Organization
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Legal Business Name | ELEVATE THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 2222 W GRAND RIVER AVE STE A
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City | OKEMOS
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State | MI
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Zip | 48864-1604
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Country | US
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Telephone | 248-266-5721
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Fax | 586-788-1704
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Provider Business Mailing Address
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Address Line | PO BOX 80143
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City | ROCHESTER
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State | MI
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Zip | 48308-0143
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Country | US
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Telephone | 248-266-5721
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Fax | 586-788-1704
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Authorized Official
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Title or Position | OWNER AND CLINICIAN
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Name | BRYAN FORTON
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Credential | DPT
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Telephone | 248-266-5721
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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