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General NPI Number Information
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NPI Number | 1386921211
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Entity Type | Organization
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Legal Business Name | ELITE CHIROPRACTIC LLC
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Dates
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Enumeration Date | 11/06/2011
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 3615 SOCIALVILLE FOSTER RD STE D
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City | MASON
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State | OH
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Zip | 45040-9054
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Country | US
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Telephone | 513-770-0534
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Fax |
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Provider Business Mailing Address
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Address Line | 3615 SOCIALVILLE FOSTER RD STE D
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City | MASON
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State | OH
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Zip | 45040-9054
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Country | US
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Telephone | 513-770-0534
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Fax | 513-770-0536
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW THOMAS KELLY
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Credential |
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Telephone | 513-770-0534
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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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