Provider Demographics
NPI:1104683119
Name:ELEVATE HEALTH CLINICS
Entity type:Organization
Organization Name:ELEVATE HEALTH CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-633-5190
Mailing Address - Street 1:4463 TOWNE LAKE PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-8230
Mailing Address - Country:US
Mailing Address - Phone:770-633-5190
Mailing Address - Fax:
Practice Address - Street 1:4463 TOWNE LAKE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-8230
Practice Address - Country:US
Practice Address - Phone:770-633-5190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty