Provider Demographics
NPI:1407919798
Name:BACK TALK CHIROPRACTIC & REHAB PC
Entity Type:Organization
Organization Name:BACK TALK CHIROPRACTIC & REHAB PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:GALANIS
Authorized Official - Suffix:
Authorized Official - Credentials:MSDC
Authorized Official - Phone:603-645-6000
Mailing Address - Street 1:4 PERSHING ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-1147
Mailing Address - Country:US
Mailing Address - Phone:603-645-6000
Mailing Address - Fax:603-625-2225
Practice Address - Street 1:4 PERSHING ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102
Practice Address - Country:US
Practice Address - Phone:603-645-6000
Practice Address - Fax:603-625-2225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1200493111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30005958Medicaid
NH=========OtherTAX ID
NH=========OtherTAX ID
NHU44186Medicare UPIN