Provider Demographics
NPI:1376730085
Name:BACK2HEALTH
Entity Type:Organization
Organization Name:BACK2HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-829-0800
Mailing Address - Street 1:15 COLUMBIA RD
Mailing Address - Street 2:#9
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-1841
Mailing Address - Country:US
Mailing Address - Phone:781-829-0800
Mailing Address - Fax:
Practice Address - Street 1:15 COLUMBIA RD
Practice Address - Street 2:#9
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-1841
Practice Address - Country:US
Practice Address - Phone:781-829-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty