Provider Demographics
NPI:1851648091
Name:ELITE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ELITE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:KOCHANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:267-495-7300
Mailing Address - Street 1:237 JACKSONVILLE RD
Mailing Address - Street 2:APT. 107E
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040-2630
Mailing Address - Country:US
Mailing Address - Phone:267-495-7300
Mailing Address - Fax:
Practice Address - Street 1:842 DURHAM RD
Practice Address - Street 2:SUITE 6
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-9683
Practice Address - Country:US
Practice Address - Phone:267-495-7300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty