# LIFE OUT LOUD, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Elevate Physical Therapy Fitness and Performance
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952947616
- **Authorized official:** JASON DANIEL TAYLOR PT, DPT (OWNER, PT)
- **Authorized official phone:** (541) 887-2030

## Contact information

- **Practice address:** 2312 S 6TH ST STE B, KLAMATH FALLS, OR 97601-4340
- **Practice address phone:** (541) 236-2123
- **Practice address fax:** (888) 706-1637
- **Mailing address:** 2312 S 6TH ST STE B, KLAMATH FALLS, OR 97601-4340
- **Mailing address phone:** (541) 887-2030
- **Mailing address fax:** (541) 887-2070

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 11/18/2019
- **Last updated:** 07/20/2020