Provider Demographics
NPI:1861811747
Name:ELITE HEALTH & WELLNESS CENTER INC
Entity type:Organization
Organization Name:ELITE HEALTH & WELLNESS CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THANG
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:DO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:571-314-4004
Mailing Address - Street 1:5659 COLUMBIA PIKE STE 200
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-2879
Mailing Address - Country:US
Mailing Address - Phone:703-933-9300
Mailing Address - Fax:
Practice Address - Street 1:5659 COLUMBIA PIKE STE 200
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-2879
Practice Address - Country:US
Practice Address - Phone:703-933-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556831111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty