Provider Demographics
NPI:1710257688
Name:ELDA, LAUREN NICOLE (DC)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:NICOLE
Last Name:ELDA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:YOUNGWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:15697-5100
Mailing Address - Country:US
Mailing Address - Phone:724-925-9220
Mailing Address - Fax:724-925-3742
Practice Address - Street 1:403 S 3RD ST
Practice Address - Street 2:
Practice Address - City:YOUNGWOOD
Practice Address - State:PA
Practice Address - Zip Code:15697-5100
Practice Address - Country:US
Practice Address - Phone:724-925-9220
Practice Address - Fax:724-925-3742
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC10490111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor