Provider Demographics
NPI:1417738915
Name:ELITE CHIROPRACTIC
Entity Type:Organization
Organization Name:ELITE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:NATHAIEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-764-6777
Mailing Address - Street 1:835 E COLONIAL AVE
Mailing Address - Street 2:
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837-4617
Mailing Address - Country:US
Mailing Address - Phone:509-764-6777
Mailing Address - Fax:509-764-6709
Practice Address - Street 1:835 E COLONIAL AVE
Practice Address - Street 2:
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-4617
Practice Address - Country:US
Practice Address - Phone:509-764-6777
Practice Address - Fax:509-764-6709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-10
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty