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General NPI Number Information
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NPI Number | 1538670302
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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 | 10/19/2017
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 301 AMES ST
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City | BALDWIN CITY
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State | KS
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Zip | 66006-4163
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Country | US
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Telephone | 785-594-1191
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Fax |
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Provider Business Mailing Address
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Address Line | 301 AMES ST
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City | BALDWIN CITY
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State | KS
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Zip | 66006-4163
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Country | US
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Telephone | 785-594-1191
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Fax | 785-594-1437
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Authorized Official
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Title or Position | OWNER
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Name | ETHAN JAMES
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Credential | DC
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Telephone | 785-594-1191
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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 | 01-05859
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License Number State | KS
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