Provider Demographics
NPI:1679236590
Name:ELITE CHIROPRACTIC PC
Entity Type:Organization
Organization Name:ELITE CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:DOWLING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:517-960-4799
Mailing Address - Street 1:1175 W LONG LAKE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-4455
Mailing Address - Country:US
Mailing Address - Phone:248-952-1900
Mailing Address - Fax:
Practice Address - Street 1:1175 W LONG LAKE RD STE 100
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-4455
Practice Address - Country:US
Practice Address - Phone:248-952-1900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-18
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty