Provider Demographics
NPI:1295431302
Name:ELEVATE FAMILY CHIROPRACTIC LLC
Entity type:Organization
Organization Name:ELEVATE FAMILY CHIROPRACTIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AO/PROVIDER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHTON-MAYER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-776-2026
Mailing Address - Street 1:5150 NORTHLAND DR NE STE B
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-1081
Mailing Address - Country:US
Mailing Address - Phone:616-314-7616
Mailing Address - Fax:
Practice Address - Street 1:5150 NORTHLAND DR NE STE B
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-1081
Practice Address - Country:US
Practice Address - Phone:616-314-7616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-01
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty