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Organization

ELITE HEALTH AND WELLNESS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICOLE LYNN TATRO MSPT (OWNER)
(802) 393-9115
Entity
Organization

Contact information

Practice address
248 N MAIN ST, SUITE 2, SAINT ALBANS, VT 05478-1554
(802) 782-8547
Mailing address
248 N MAIN ST, SUITE 2, SAINT ALBANS, VT 05478-1554
(802) 782-8547

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0400003460
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1018306
VT
Enumeration date
10/29/2010
Last updated
01/10/2014
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