MEDICARE: FIVE ELEMENTS WELLNESS, LLC

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	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1952633893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIVE ELEMENTS WELLNESS, LLC

Provider Business Mailing Address
First Line	:	14 E BUTLER RD STE C
Second Line	:
City	:	MAULDIN
State	:	SC
Zip	:	29662-2402
Country	:	US
Telephone Number	:	706-201-1219
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 E BUTLER RD STE C
Second Line	:
City	:	MAULDIN
State	:	SC
Zip	:	29662-2402
Country	:	US
Telephone Number	:	864-297-6270
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. NICHOLAS ADRIAN HIGHTOWER
Credential	:	DC
Telephone Number	:	864-297-6270

Provider Enumeration Date	:	02/03/2010
Last Update Date	:	06/17/2019

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Directions to “FIVE ELEMENTS WELLNESS, LLC ” Practice Location

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