Healthcare Provider Details

I. General information

NPI: 1942513551
Provider Name (Legal Business Name): ELEMENTS TO WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2010
Last Update Date: 01/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 HEARTHSTONE CT SUITE 200
READING PA
19606-3065
US

IV. Provider business mailing address

6 HEARTHSTONE CT SUITE 200
READING PA
19606-3065
US

V. Phone/Fax

Practice location:
  • Phone: 610-685-1761
  • Fax: 610-779-3392
Mailing address:
  • Phone: 610-685-1761
  • Fax: 610-779-3392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMSG000214
License Number StatePA

VIII. Authorized Official

Name: MRS. MORGAN E MILLER
Title or Position: OWNER
Credential: LMT, LST
Phone: 610-685-1761