Provider Demographics
NPI:1376241711
Name:BACKTOMIND TAMARAC
Entity Type:Organization
Organization Name:BACKTOMIND TAMARAC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LIAT
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-986-4559
Mailing Address - Street 1:3990 SHERIDAN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3656
Mailing Address - Country:US
Mailing Address - Phone:954-986-4559
Mailing Address - Fax:954-986-4526
Practice Address - Street 1:7431 N UNIVERSITY DR STE 206
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2956
Practice Address - Country:US
Practice Address - Phone:954-986-4559
Practice Address - Fax:954-986-4526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty