Provider Demographics
NPI:1427227495
Name:BACKBONE OF HEALTH LLC
Entity Type:Organization
Organization Name:BACKBONE OF HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:WEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-764-3434
Mailing Address - Street 1:3985 MEDINA RD STE 220
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-5968
Mailing Address - Country:US
Mailing Address - Phone:330-764-3434
Mailing Address - Fax:330-608-1773
Practice Address - Street 1:3985 MEDINA RD STE 220
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-5968
Practice Address - Country:US
Practice Address - Phone:330-764-3434
Practice Address - Fax:330-608-1773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHWE4152541Medicare PIN
OHV04038Medicare UPIN