Provider Demographics
NPI:1598878407
Name:ELITE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ELITE CHIROPRACTIC LLC
Other - Org Name:GLOBAL CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:AL
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:ENRIQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-491-7241
Mailing Address - Street 1:4435 S RURAL RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282
Mailing Address - Country:US
Mailing Address - Phone:480-491-7241
Mailing Address - Fax:480-491-7235
Practice Address - Street 1:4435 S RURAL RD
Practice Address - Street 2:SUITE 4
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282
Practice Address - Country:US
Practice Address - Phone:480-491-7241
Practice Address - Fax:480-491-7235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7659111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty