Provider Demographics
NPI:1588299119
Name:ELITE SPINAL HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:ELITE SPINAL HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-459-7785
Mailing Address - Street 1:1220 E CHURCHVILLE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3414
Mailing Address - Country:US
Mailing Address - Phone:410-459-7785
Mailing Address - Fax:443-819-3135
Practice Address - Street 1:1220 E CHURCHVILLE RD STE 300
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3414
Practice Address - Country:US
Practice Address - Phone:410-459-7785
Practice Address - Fax:443-819-3135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty