Provider Demographics
NPI:1124416193
Name:BACK SAFETY & WELLNESS CENTER, INC.
Entity Type:Organization
Organization Name:BACK SAFETY & WELLNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUMSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:708-365-6353
Mailing Address - Street 1:18141 DIXIE HWY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-2238
Mailing Address - Country:US
Mailing Address - Phone:708-365-6353
Mailing Address - Fax:
Practice Address - Street 1:18141 DIXIE HWY
Practice Address - Street 2:SUITE 107
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-2238
Practice Address - Country:US
Practice Address - Phone:708-365-6353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-29
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty