Provider Demographics
NPI:1619692704
Name:CHIROPRACTIC HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:CHIROPRACTIC HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:KALANTAROV
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:646-463-4031
Mailing Address - Street 1:6199 RIVERWALK LN UNIT 5
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7906
Mailing Address - Country:US
Mailing Address - Phone:646-463-4031
Mailing Address - Fax:561-626-6733
Practice Address - Street 1:10088 W INDIANTOWN RD
Practice Address - Street 2:STE B
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33478
Practice Address - Country:US
Practice Address - Phone:646-463-4031
Practice Address - Fax:561-626-6733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty