Provider Demographics
NPI:1467223222
Name:BACK TO FUNCTION REHAB AND WELLNESS
Entity Type:Organization
Organization Name:BACK TO FUNCTION REHAB AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST, CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:STERLING
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:817-623-4803
Mailing Address - Street 1:4401 THOUSAND OAKS DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-1332
Mailing Address - Country:US
Mailing Address - Phone:817-623-4803
Mailing Address - Fax:855-509-1183
Practice Address - Street 1:711 E ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-5017
Practice Address - Country:US
Practice Address - Phone:817-623-4803
Practice Address - Fax:855-509-1183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy