Organization
ELEVATION CHIROPRACTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW UCHTMAN D.C. (OWNER)
(573) 450-8088
Entity
Organization
Contact information
Practice address
1812 CARONDALET DR, SUITE 102, CAPE GIRARDEAU, MO 63701-2285
(573) 450-8088
Mailing address
1812 CARONDALET DR, SUITE 102, CAPE GIRARDEAU, MO 63701-2285
(573) 450-8088
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2011005972
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356531420
INDIVIDUAL NPI
—
01
—
2011005972
MO LICENSE
MO
Enumeration date
02/15/2012
Last updated
02/15/2012
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