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General NPI Number Information
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NPI Number | 1548415359
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Entity Type | Organization
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Legal Business Name | CORE ELEMENTS LLC
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Dates
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Enumeration Date | 11/20/2008
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Last Update Date | 11/20/2008
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Provider Practice Location Address
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Address Line | 3535 MILITARY TRL SUITE 203
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City | JUPITER
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State | FL
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Zip | 33458-5009
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Country | US
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Telephone | 561-744-9191
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Fax | 561-744-9198
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Provider Business Mailing Address
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Address Line | 3535 MILITARY TRL SUITE 203
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City | JUPITER
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State | FL
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Zip | 33458-5009
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Country | US
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Telephone | 561-744-9191
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Fax | 561-744-9198
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Authorized Official
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Title or Position | PRESIDENT
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Name | AARON SPECTOR
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Credential | DPT
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Telephone | 561-744-9191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT18942
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License Number State | FL
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