Healthcare Provider Details

I. General information

NPI: 1356858039
Provider Name (Legal Business Name): COMPLETE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2018
Last Update Date: 01/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 ANGLERS RD UNIT 101
LEWES DE
19958-1192
US

IV. Provider business mailing address

18766 JOHN J WILLIAMS HWY STE 316
REHOBOTH BEACH DE
19971-4417
US

V. Phone/Fax

Practice location:
  • Phone: 302-644-8494
  • Fax:
Mailing address:
  • Phone: 703-403-9439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0000965
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number0000965
License Number StateDE

VIII. Authorized Official

Name: JOANNE C HUTTON
Title or Position: DOCTOR
Credential: DC
Phone: 703-403-9439