Provider Demographics
NPI:1114229952
Name:ELEMENTS TOTAL HEALTH CENTER
Entity Type:Organization
Organization Name:ELEMENTS TOTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROXY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:616-441-1888
Mailing Address - Street 1:1605 HOPE ST STE 350
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-2658
Mailing Address - Country:US
Mailing Address - Phone:626-441-1888
Mailing Address - Fax:626-441-1889
Practice Address - Street 1:1605 HOPE ST STE 350
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-2658
Practice Address - Country:US
Practice Address - Phone:626-441-1888
Practice Address - Fax:626-441-1889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty