Healthcare Provider Details

I. General information

NPI: 1952692931
Provider Name (Legal Business Name): ALLEVIATE WELLNESS CENTER OF NELSON LEE CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2011
Last Update Date: 02/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2560 W OLYMPIC BLVD STE 201
LOS ANGELES CA
90006-2972
US

IV. Provider business mailing address

2560 W OLYMPIC BLVD STE 201
LOS ANGELES CA
90006-2972
US

V. Phone/Fax

Practice location:
  • Phone: 213-383-0007
  • Fax: 866-505-1544
Mailing address:
  • Phone: 213-383-0007
  • Fax: 866-505-1544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC7286
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC29495
License Number StateCA

VIII. Authorized Official

Name: NELSON LEE
Title or Position: PRESIDENT
Credential: D.C., L.AC.
Phone: 213-383-0007