Provider Demographics
NPI:1992131668
Name:ELEVATE CHIROPRACTIC, JIMMY SAYEGH CHIROPRACTIC CORP.
Entity type:Organization
Organization Name:ELEVATE CHIROPRACTIC, JIMMY SAYEGH CHIROPRACTIC CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:RIMON
Authorized Official - Last Name:SAYEGH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:909-989-6980
Mailing Address - Street 1:10165 FOOTHILL BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-0340
Mailing Address - Country:US
Mailing Address - Phone:909-989-6980
Mailing Address - Fax:909-927-8262
Practice Address - Street 1:10165 FOOTHILL BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-0340
Practice Address - Country:US
Practice Address - Phone:909-989-6980
Practice Address - Fax:909-927-8262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-25
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32515111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty