Provider Demographics
NPI:1124222765
Name:BACK ON TRACK CHIROPRACTIC AND WELLNESS CENTER PC
Entity Type:Organization
Organization Name:BACK ON TRACK CHIROPRACTIC AND WELLNESS CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCHERER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:205-967-6776
Mailing Address - Street 1:2031B CAHABA ROAD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BROOK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-1109
Mailing Address - Country:US
Mailing Address - Phone:205-967-6776
Mailing Address - Fax:205-967-6673
Practice Address - Street 1:2031B CAHABA ROAD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BROOK
Practice Address - State:AL
Practice Address - Zip Code:35223-1109
Practice Address - Country:US
Practice Address - Phone:205-967-6776
Practice Address - Fax:205-967-6673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAL1405111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALU44485Medicare UPIN
ALU44485Medicare UPIN