Provider Demographics
NPI:1538501366
Name:ELITE HEALTH & WELLNESS P.C.
Entity Type:Organization
Organization Name:ELITE HEALTH & WELLNESS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:MAEYAERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:712-339-4848
Mailing Address - Street 1:2220 33RD ST STE A
Mailing Address - Street 2:
Mailing Address - City:SPIRIT LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51360-7715
Mailing Address - Country:US
Mailing Address - Phone:507-530-8406
Mailing Address - Fax:712-336-4980
Practice Address - Street 1:2220 33RD ST STE A
Practice Address - Street 2:
Practice Address - City:SPIRIT LAKE
Practice Address - State:IA
Practice Address - Zip Code:51360-7715
Practice Address - Country:US
Practice Address - Phone:507-530-8406
Practice Address - Fax:712-336-4980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-22
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007652111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty