Provider Demographics
NPI:1104242593
Name:ELEVATION HEALTH S. ARLINGTON LLC
Entity type:Organization
Organization Name:ELEVATION HEALTH S. ARLINGTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COFOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:LABRECQUE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-577-6061
Mailing Address - Street 1:4623 S COOPER ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-5827
Mailing Address - Country:US
Mailing Address - Phone:817-697-2560
Mailing Address - Fax:817-577-2345
Practice Address - Street 1:4623 S COOPER ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-5827
Practice Address - Country:US
Practice Address - Phone:817-318-5472
Practice Address - Fax:817-577-2345
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEXAGON HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-10
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty