Organization
ELEVATE THERAPY & PERFORMANCE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CODY B DOERFLEIN DPT (OWNER)
(618) 549-0225
Entity
Organization
Contact information
Practice address
214 W FREEMAN ST, CARBONDALE, IL 62901-2809
(812) 491-1307
(618) 549-0226
Mailing address
PO BOX 3276, EVANSVILLE, IN 47731-3276
(812) 473-0181
(812) 473-5822
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070024815
STATE LICENSE
IL
Enumeration date
01/08/2020
Last updated
11/09/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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