Provider Demographics
NPI:1497229512
Name:ELEMENT CHIROPRACTIC & WELLNESS, LLC
Entity Type:Organization
Organization Name:ELEMENT CHIROPRACTIC & WELLNESS, LLC
Other - Org Name:ELEMENT CHIROPRACTIC & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRISH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-505-9170
Mailing Address - Street 1:90 LAKE PINES DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-7678
Mailing Address - Country:US
Mailing Address - Phone:248-343-4210
Mailing Address - Fax:
Practice Address - Street 1:50200 DENNIS CT
Practice Address - Street 2:
Practice Address - City:WIXOM
Practice Address - State:MI
Practice Address - Zip Code:48393-2021
Practice Address - Country:US
Practice Address - Phone:248-505-9170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-12
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty