Organization
ELW HEALTH CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN LEE WAYCHOFF DC (OWNER)
(602) 284-8994
Entity
Organization
Contact information
Practice address
3202 E GREENWAY RD STE 1619, PHOENIX, AZ 85032-4553
(602) 284-8994
(602) 346-9007
Mailing address
3202 E GREENWAY RD STE 1619, PHOENIX, AZ 85032-4553
(602) 284-8994
(602) 346-9007
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
37050
AZ
305S00000X
Point of Service
40062
AZ
305S00000X
Point of Service
42847
—
305S00000X
Point of Service
Primary
AP2129
AZ
305S00000X
Point of Service
AP2433
AZ
305S00000X
Point of Service
AP3569
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417912700
CMS
AZ
Enumeration date
03/25/2015
Last updated
04/01/2015
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