| NPI | 1336193119 |
|---|---|
| Doing Business As | ELITE SPINE AND SPORT CENTER |
| Entity Type | Organization |
| Authorized Contact | BRYAN C RUSSELL Owner 856-983-4499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2023-12-28 |