# ELEVATION CHIROPRACTIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407129992
- **Authorized official:** DR. MATTHEW UCHTMAN D.C. (OWNER)
- **Authorized official phone:** (573) 450-8088

## Contact information

- **Practice address:** 1812 CARONDALET DR, SUITE 102, CAPE GIRARDEAU, MO 63701-2285
- **Practice address phone:** (573) 450-8088
- **Mailing address:** 1812 CARONDALET DR, SUITE 102, CAPE GIRARDEAU, MO 63701-2285
- **Mailing address phone:** (573) 450-8088

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 2011005972 | MO | Yes |

## Other

- **Enumeration date:** 02/15/2012
- **Last updated:** 02/15/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1356531420 | INDIVIDUAL NPI | — |
| 01 | — | 2011005972 | MO LICENSE | MO |