Organization
ELEVATE REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE L MAZUR (OWNER)
(307) 335-3471
Entity
Organization
Contact information
Practice address
545 E MAIN ST STE B, LANDER, WY 82520-3470
(307) 335-3471
(307) 332-5388
Mailing address
545 E MAIN ST STE B, LANDER, WY 82520-3470
(307) 335-3471
(307) 332-5388
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
07/11/2013
Last updated
04/07/2025
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