Provider Demographics
NPI:1326360272
Name:BACK TO HEALTH FAMILY CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:BACK TO HEALTH FAMILY CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KEEFE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:802-527-2225
Mailing Address - Street 1:387 LAKE RD STE 3
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:VT
Mailing Address - Zip Code:05478-2268
Mailing Address - Country:US
Mailing Address - Phone:802-527-2225
Mailing Address - Fax:802-527-2013
Practice Address - Street 1:387 LAKE RD STE 3
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-2268
Practice Address - Country:US
Practice Address - Phone:802-527-2225
Practice Address - Fax:802-527-2013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VTVT982111N00000X, 111NN1001X
VTVT 982111NT0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
No111NT0100XChiropractic ProvidersChiropractorThermographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN 1419Medicaid