Provider Demographics
NPI:1982377560
Name:THE SHIFT WITH DR. ELLEN
Entity Type:Organization
Organization Name:THE SHIFT WITH DR. ELLEN
Other - Org Name:BODY HARMONY OF ARLINGTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZENRIDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-679-8619
Mailing Address - Street 1:3800 FAIRFAX DR APT 1703
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-1723
Mailing Address - Country:US
Mailing Address - Phone:757-679-8619
Mailing Address - Fax:
Practice Address - Street 1:3033 WILSON BLVD STE 700
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-3868
Practice Address - Country:US
Practice Address - Phone:703-963-4257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-29
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty