Provider Demographics
NPI:1619685229
Name:ELEMENTAL HEALING LLC
Entity type:Organization
Organization Name:ELEMENTAL HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:FABIJANIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-618-1537
Mailing Address - Street 1:3950 MIDLAND AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-4605
Mailing Address - Country:US
Mailing Address - Phone:970-618-1537
Mailing Address - Fax:970-930-6150
Practice Address - Street 1:3950 MIDLAND AVE STE 3
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-4605
Practice Address - Country:US
Practice Address - Phone:970-618-1537
Practice Address - Fax:970-930-6150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service