Provider Demographics
NPI:1053129320
Name:ELEVATE CHIROPRACTIC & WELLNESS
Entity type:Organization
Organization Name:ELEVATE CHIROPRACTIC & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CEO
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:JORDAN
Authorized Official - Last Name:DIGIOVANNI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-330-5305
Mailing Address - Street 1:20 SUN HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-1865
Mailing Address - Country:US
Mailing Address - Phone:732-330-5305
Mailing Address - Fax:
Practice Address - Street 1:70 SCHANCK RD
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-5309
Practice Address - Country:US
Practice Address - Phone:732-330-5305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty