Provider Demographics
NPI:1508297029
Name:ELITE CHIROPRACTIC HEALING CLINICS
Entity Type:Organization
Organization Name:ELITE CHIROPRACTIC HEALING CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASISTANT
Authorized Official - Prefix:MISS
Authorized Official - First Name:ONAIKA
Authorized Official - Middle Name:BENITEZ
Authorized Official - Last Name:SEGUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-777-1171
Mailing Address - Street 1:300 FELISA RINCON DE GAUTIER
Mailing Address - Street 2:LAS VISTA SHOPPING VILLAGE STE 9
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6088
Mailing Address - Country:US
Mailing Address - Phone:787-777-1171
Mailing Address - Fax:787-777-1172
Practice Address - Street 1:300 FELISA RINCON DE GAUTIER
Practice Address - Street 2:LAS VISTA SHOPPING VILLAGE STE 9
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6088
Practice Address - Country:US
Practice Address - Phone:787-777-1171
Practice Address - Fax:787-777-1172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty