Provider Demographics
NPI:1679293906
Name:ELEVATE CHIROPRACTIC
Entity type:Organization
Organization Name:ELEVATE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:HARSHFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:937-210-5525
Mailing Address - Street 1:190 REYNOLDS AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-3004
Mailing Address - Country:US
Mailing Address - Phone:937-210-5525
Mailing Address - Fax:937-210-5526
Practice Address - Street 1:190 REYNOLDS AVE
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-3004
Practice Address - Country:US
Practice Address - Phone:937-935-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1679293906OtherGROUP NPI
OH1962900951OtherSOLO NPI