MEDICARE: ELITE CHIROPRACTIC & THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1316747124
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE CHIROPRACTIC & THERAPY

Provider Business Mailing Address
First Line	:	7423 LAS COLINAS BLVD STE 100
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-7564
Country	:	US
Telephone Number	:	469-864-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	7423 LAS COLINAS BLVD STE 100
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-7564
Country	:	US
Telephone Number	:	469-864-1000
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. MARIE WEBSTER-GERSTMAN
Credential	:
Telephone Number	:	469-864-1000

Provider Enumeration Date	:	03/19/2025
Last Update Date	:	03/19/2025

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