Provider Demographics
NPI:1497634174
Name:ELITE LASER PAIN & CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:ELITE LASER PAIN & CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:DIAL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:910-736-4999
Mailing Address - Street 1:470 MAGNOLIA SQUARE CT
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:NC
Mailing Address - Zip Code:28315-2763
Mailing Address - Country:US
Mailing Address - Phone:410-900-3758
Mailing Address - Fax:910-900-3768
Practice Address - Street 1:470 MAGNOLIA SQUARE CT
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:NC
Practice Address - Zip Code:28315-2763
Practice Address - Country:US
Practice Address - Phone:410-900-3758
Practice Address - Fax:910-900-3768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty