Provider Demographics
NPI:1912341140
Name:ELITE CHIROPRACTIC AND WELLNESS. LLC
Entity Type:Organization
Organization Name:ELITE CHIROPRACTIC AND WELLNESS. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRECHLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-460-3490
Mailing Address - Street 1:19888 N 73RD AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8904
Mailing Address - Country:US
Mailing Address - Phone:602-460-3490
Mailing Address - Fax:952-658-1923
Practice Address - Street 1:19888 N 73RD AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8904
Practice Address - Country:US
Practice Address - Phone:602-460-3490
Practice Address - Fax:952-658-1923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-18
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty