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General NPI Number Information
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NPI Number | 1235388471
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Entity Type | Organization
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Legal Business Name | ELITE REHAB AND CHIROPRACTIC CARE
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Dates
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Enumeration Date | 09/11/2008
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Last Update Date | 09/11/2008
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Provider Practice Location Address
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Address Line | 504 E 2ND ST
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-3810
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Country | US
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Telephone | 956-487-1304
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Fax |
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Provider Business Mailing Address
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Address Line | 504 E 2ND ST
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-3810
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOEL ADALBERTO GONZALEZ
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Credential |
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Telephone | 956-487-1304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | F007526
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License Number State | TX
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