Organization
ELEVATE SPORT AND SPINE, LLC
Active
Other names
Dr. Preston S. Douglas, DC
Organization subpart
No
Provider details
NPI number
Authorized official
PRESTON S DOUGLAS DC, CCSP, ATC (OWNER/CEO/CHIROPRACTOR)
(423) 239-9122
Entity
Organization
Contact information
Practice address
101 PROFESSIONAL PARK PVT DR, KINGSPORT, TN 37663-2288
(423) 239-9122
(423) 239-7991
Mailing address
4012 FORT HENRY DR, KINGSPORT, TN 37663-2028
(423) 502-3776
(423) 239-7991
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
2255A2300X
Athletic Trainer
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q070613
—
TN
Enumeration date
11/09/2021
Last updated
06/05/2024
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