Provider Demographics
NPI:1609648062
Name:ELITE INTEGRAL STAFFING LLC
Entity Type:Organization
Organization Name:ELITE INTEGRAL STAFFING LLC
Other - Org Name:ELITE INTEGRAL STAFFING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:GLEN
Authorized Official - Last Name:CRANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:719-688-1483
Mailing Address - Street 1:372 URY RD
Mailing Address - Street 2:
Mailing Address - City:CADDO
Mailing Address - State:OK
Mailing Address - Zip Code:74729-4105
Mailing Address - Country:US
Mailing Address - Phone:719-688-1483
Mailing Address - Fax:
Practice Address - Street 1:372 URY RD
Practice Address - Street 2:
Practice Address - City:CADDO
Practice Address - State:OK
Practice Address - Zip Code:74729-4105
Practice Address - Country:US
Practice Address - Phone:719-688-1483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty