Provider Demographics
NPI:1407167745
Name:BACK FIT INC. LLC
Entity Type:Organization
Organization Name:BACK FIT INC. LLC
Other - Org Name:DIAMOND SPINE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:STINNETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-347-2225
Mailing Address - Street 1:1450 W GRAND PKWY S
Mailing Address - Street 2:SUITE M
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-8286
Mailing Address - Country:US
Mailing Address - Phone:281-347-2225
Mailing Address - Fax:928-563-5317
Practice Address - Street 1:1450 W GRAND PKWY S
Practice Address - Street 2:SUITE M
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-8286
Practice Address - Country:US
Practice Address - Phone:281-347-2225
Practice Address - Fax:928-563-5317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7073111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty