Provider Demographics
NPI:1174868889
Name:ELITE CHIROPRACTIC & WELLNESS CENTER
Entity type:Organization
Organization Name:ELITE CHIROPRACTIC & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACI
Authorized Official - Middle Name:
Authorized Official - Last Name:ADDESSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-739-3345
Mailing Address - Street 1:1 BETHANY RD
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1663
Mailing Address - Country:US
Mailing Address - Phone:732-739-3345
Mailing Address - Fax:
Practice Address - Street 1:1 BETHANY RD
Practice Address - Street 2:STE #29
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1663
Practice Address - Country:US
Practice Address - Phone:732-739-3345
Practice Address - Fax:732-739-3376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty