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NPI Code Detail

MEDICARE: ELEVATION SPINE AND SPORTS MEDICINE PLLC

MEDICARE: ELEVATION SPINE AND SPORTS MEDICINE PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor

General Provider Information

NPI Number : 1891481867
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELEVATION SPINE AND SPORTS MEDICINE PLLC
Provider Business Mailing Address
First Line : 2761 E TRINITY MILLS RD STE 100
Second Line :
City : CARROLLTON
State : TX
Zip : 75006-3507
Country : US
Telephone Number : 214-233-5512
Fax Number :
Provider Business Practice Location Address
First Line : 2761 E TRINITY MILLS RD STE 100
Second Line :
City : CARROLLTON
State : TX
Zip : 75006-3507
Country : US
Telephone Number : 214-233-5512
Fax Number :
Authorized Official
Title or Position : CHIROPRACTOR/OWNER
Name : DR. KONNER ACKERMAN
Credential : DC
Telephone Number : 214-233-5512
Provider Enumeration Date : 04/13/2023
Last Update Date : 04/13/2023

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Directions to “ELEVATION SPINE AND SPORTS MEDICINE PLLC ” Practice Location

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