Organization
ELEVATION PROSTHETICS AND ORTHOTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL CARLSON CPO (PRESIDENT)
(916) 297-7853
Entity
Organization
Contact information
Practice address
106 N SUNRISE AVE STE C8, ROSEVILLE, CA 95661-2914
(916) 297-7853
Mailing address
106 N SUNRISE AVE STE C8, ROSEVILLE, CA 95661-2914
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902084239
NPI
—
Enumeration date
10/19/2018
Last updated
10/19/2018
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