Provider Demographics
NPI:1285875096
Name:ELITE CHIROPRACTIC HEALTH & REHABILITATION, PLLC
Entity type:Organization
Organization Name:ELITE CHIROPRACTIC HEALTH & REHABILITATION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAYLA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SWANSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:479-287-4070
Mailing Address - Street 1:237 E MILLSAP RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-6288
Mailing Address - Country:US
Mailing Address - Phone:479-287-4070
Mailing Address - Fax:479-287-4072
Practice Address - Street 1:237 E MILLSAP RD
Practice Address - Street 2:SUITE 8
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-6288
Practice Address - Country:US
Practice Address - Phone:479-287-4070
Practice Address - Fax:479-287-4072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR15623111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty