Provider Demographics
NPI:1811536667
Name:ELEMENTS IN WELLNESS
Entity Type:Organization
Organization Name:ELEMENTS IN WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHETT
Authorized Official - Middle Name:
Authorized Official - Last Name:MALLETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:619-600-1492
Mailing Address - Street 1:3535 CAHUENGA BLVD W STE 206
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90068-1359
Mailing Address - Country:US
Mailing Address - Phone:323-600-4303
Mailing Address - Fax:
Practice Address - Street 1:3535 CAHUENGA BLVD W STE 206
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90068-1359
Practice Address - Country:US
Practice Address - Phone:323-600-4303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty