Provider Demographics
NPI:1922850106
Name:ELITE CHIROPRACTIC & WELLNESS, LLC
Entity Type:Organization
Organization Name:ELITE CHIROPRACTIC & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-217-0550
Mailing Address - Street 1:12001 AVALON LAKE DR STE E1
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7375
Mailing Address - Country:US
Mailing Address - Phone:407-300-3204
Mailing Address - Fax:
Practice Address - Street 1:12001 AVALON LAKE DR STE E1
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-7375
Practice Address - Country:US
Practice Address - Phone:407-300-3204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty