Provider Demographics
NPI:1265178495
Name:ELITE PERFORMANCE AND WELLNESS CENTER A CHENEY CHIROPRACTIC CORP
Entity type:Organization
Organization Name:ELITE PERFORMANCE AND WELLNESS CENTER A CHENEY CHIROPRACTIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LAC, DACBSP
Authorized Official - Phone:888-608-6165
Mailing Address - Street 1:24009 VENTURA BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-2550
Mailing Address - Country:US
Mailing Address - Phone:888-608-6165
Mailing Address - Fax:818-208-7074
Practice Address - Street 1:24009 VENTURA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-2550
Practice Address - Country:US
Practice Address - Phone:888-608-6165
Practice Address - Fax:818-208-7074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-10
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty