Provider Demographics
NPI:1346582491
Name:BACK-N-ACTION PT LLC
Entity Type:Organization
Organization Name:BACK-N-ACTION PT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:T
Authorized Official - Last Name:NESBIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-762-1515
Mailing Address - Street 1:500 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:PARK FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54552-1415
Mailing Address - Country:US
Mailing Address - Phone:715-762-1515
Mailing Address - Fax:715-762-1599
Practice Address - Street 1:500 BIRCH ST
Practice Address - Street 2:
Practice Address - City:PARK FALLS
Practice Address - State:WI
Practice Address - Zip Code:54552-1415
Practice Address - Country:US
Practice Address - Phone:715-762-1515
Practice Address - Fax:715-762-1599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3939225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty