Organization
ELEVATE HEALTH CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL M SAMUEL D.C. (REGISTERED AGENT)
(802) 318-7835
Entity
Organization
Contact information
Practice address
595 DORSET ST STE 8, SOUTH BURLINGTON, VT 05403-6240
(802) 557-8568
Mailing address
595 DORSET ST STE 8, SOUTH BURLINGTON, VT 05403-6240
(802) 557-8568
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
006.0001179
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021668
—
VT
Enumeration date
09/23/2014
Last updated
10/24/2014
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