Healthcare Provider Details

I. General information

NPI: 1235453374
Provider Name (Legal Business Name): ELEMENTS CENTER INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2010
Last Update Date: 03/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2233 WISCONSIN AVE NW SUITE 217
WASHINGTON DC
20007-4104
US

IV. Provider business mailing address

2233 WISCONSIN AVE NW SUITE 217
WASHINGTON DC
20007-4104
US

V. Phone/Fax

Practice location:
  • Phone: 202-333-5252
  • Fax: 202-333-1159
Mailing address:
  • Phone: 202-333-5252
  • Fax: 202-333-1159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT870544
License Number StateDC

VIII. Authorized Official

Name: DR. JUSTINE LYNN BERNARD
Title or Position: OWNER, PRESIDENT
Credential: PT, DPT
Phone: 202-333-5252