Organization
ELITE WELLNESS
Active
Other names
Elite Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MISHELL RONICA BROOKINS (PRESIDENT)
(617) 522-4397
Entity
Organization
Contact information
Practice address
18 HYDE PARK AVE, SUITE 4, JAMAICA PLAIN, MA 02130-4163
(617) 522-4397
Mailing address
18 HYDE PARK AVE, SUITE 4, JAMAICA PLAIN, MA 02130-4163
(617) 522-4397
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Enumeration date
07/17/2009
Last updated
07/17/2009
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