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General NPI Number Information
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NPI Number | 1881367357
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Entity Type | Organization
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Legal Business Name | ELEVATED LIVING CHIROPRACTIC LLC
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Dates
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Enumeration Date | 07/29/2021
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Last Update Date | 07/29/2021
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Provider Practice Location Address
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Address Line | 102 GRANT ST
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City | AURORA
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State | NE
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Zip | 68818-3200
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Country | US
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Telephone | 402-819-9549
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Fax |
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Provider Business Mailing Address
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Address Line | 36234 535 AVE
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City | SAINT EDWARD
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State | NE
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Zip | 68660-6055
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DEVON RASMUSSEN
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Credential | DC
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Telephone | 402-819-9549
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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 |
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License Number State |
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