Provider Demographics
NPI:1174112643
Name:ELEVATION WELLNESS
Entity type:Organization
Organization Name:ELEVATION WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:STOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, ATC, CHT
Authorized Official - Phone:301-512-4327
Mailing Address - Street 1:6573 BENTON CIR
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-4733
Mailing Address - Country:US
Mailing Address - Phone:720-815-6433
Mailing Address - Fax:720-780-6930
Practice Address - Street 1:6573 BENTON CIR
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-4733
Practice Address - Country:US
Practice Address - Phone:720-815-6433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-11
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy