Provider Demographics
NPI:1437275153
Name:BACK WORKS UNLTD INC
Entity Type:Organization
Organization Name:BACK WORKS UNLTD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-493-2882
Mailing Address - Street 1:2149 CASCADE AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1087
Mailing Address - Country:US
Mailing Address - Phone:509-493-2882
Mailing Address - Fax:509-493-2882
Practice Address - Street 1:1000 W STEUBEN ST
Practice Address - Street 2:
Practice Address - City:BINGEN
Practice Address - State:WA
Practice Address - Zip Code:98605
Practice Address - Country:US
Practice Address - Phone:509-493-2882
Practice Address - Fax:509-493-2882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1407862OtherBLUE CROSS BLUE SHIELD
WA14971OtherLABOR & INDUSTRIES
WA14971OtherLABOR & INDUSTRIES
X59030Medicare UPIN