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General NPI Number Information
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NPI Number | 1982499281
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Entity Type | Organization
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Legal Business Name | ELEVATE PELVIC THERAPY LLC
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Dates
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Enumeration Date | 04/09/2025
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 100 CHARLESTON CT
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City | WARNER ROBINS
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State | GA
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Zip | 31088-2544
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Country | US
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Telephone | 478-291-6316
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Fax |
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Provider Business Mailing Address
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Address Line | 8735 DUNWOODY PL STE N
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City | ATLANTA
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State | GA
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Zip | 30350-2995
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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 | OWNER/OPERATOR
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Name | KRISTEN A HULL
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Credential | OTR/L
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Telephone | 478-291-6316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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