Provider Demographics
NPI:1386821643
Name:BACK TO HEALTH FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:BACK TO HEALTH FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-522-7557
Mailing Address - Street 1:118 E RIO GRANDE AVE
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08260-4527
Mailing Address - Country:US
Mailing Address - Phone:609-522-7557
Mailing Address - Fax:609-522-7557
Practice Address - Street 1:118 E RIO GRANDE AVE
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08260-4527
Practice Address - Country:US
Practice Address - Phone:609-522-7557
Practice Address - Fax:609-522-7557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00488700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty