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General NPI Number Information
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NPI Number | 1578076642
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Entity Type | Organization
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Legal Business Name | ELEVATE CHIROPRACTIC & WELLNESS CENTER
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Dates
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Enumeration Date | 11/13/2017
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Last Update Date | 12/05/2017
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Provider Practice Location Address
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Address Line | 4250 SARON DR
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City | LEXINGTON
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State | KY
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Zip | 40515-6483
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Country | US
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Telephone | 859-629-3131
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Fax | 859-629-3132
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Provider Business Mailing Address
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Address Line | 1129 ARMSTRONG MILL RD
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City | LEXINGTON
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State | KY
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Zip | 40517-3106
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Country | US
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Telephone | 859-537-0261
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIROPRACTIC DIRECTOR
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Name | CHRISTIAN THOMAS ROSEVEAR
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Credential | DC
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Telephone | 859-537-0261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5140
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License Number State | KY
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