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General NPI Number Information
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NPI Number | 1306426663
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Entity Type | Organization
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Legal Business Name | ELITE CHIROPRACTIC & WELLNESS CENTER INC
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Dates
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Enumeration Date | 04/12/2021
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Last Update Date | 04/12/2021
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Provider Practice Location Address
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Address Line | 3750 GUNN HWY STE 207
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City | TAMPA
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State | FL
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Zip | 33618-8914
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Country | US
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Telephone | 813-327-0072
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Fax | 813-944-4946
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Provider Business Mailing Address
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Address Line | 16136 SAGEBRUSH RD
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City | TAMPA
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State | FL
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Zip | 33618-1314
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Country | US
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Telephone | 813-327-0072
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Fax |
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Authorized Official
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Title or Position | DC, OWNER
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Name | NADIUSKA G LOPEZ
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Credential | DC
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Telephone | 813-327-0072
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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 |
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License Number State |
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