Healthcare Provider Details

I. General information

NPI: 1780290726
Provider Name (Legal Business Name): COMPLETE WELL BEING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2020
Last Update Date: 10/19/2020
Certification Date: 10/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W ATLANTIC AVE # 14
DELRAY BEACH FL
33444-3689
US

IV. Provider business mailing address

401 W ATLANTIC AVE # 14
DELRAY BEACH FL
33444-3689
US

V. Phone/Fax

Practice location:
  • Phone: 561-330-6096
  • Fax: 561-330-6097
Mailing address:
  • Phone: 561-330-6096
  • Fax: 561-330-6097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: HELENE ELENGOLD
Title or Position: PRACTICE MANAGER
Credential:
Phone: 561-330-6096