Provider Demographics
NPI:1306573498
Name:ELEVATION PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:ELEVATION PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ENEZ
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:725-201-1733
Mailing Address - Street 1:3005 W HORIZON RIDGE PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-5030
Mailing Address - Country:US
Mailing Address - Phone:702-840-2500
Mailing Address - Fax:725-234-1515
Practice Address - Street 1:3005 W HORIZON RIDGE PKWY STE 101
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5030
Practice Address - Country:US
Practice Address - Phone:702-840-2500
Practice Address - Fax:725-234-1515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty