Provider Demographics
NPI:1598104879
Name:SCIENCE BASED NUTRITION INC
Entity Type:Organization
Organization Name:SCIENCE BASED NUTRITION INC
Other - Org Name:BACK TO HEALTH CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:MERKLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DABCI,
Authorized Official - Phone:937-433-3241
Mailing Address - Street 1:5777 FAR HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-2207
Mailing Address - Country:US
Mailing Address - Phone:937-433-3241
Mailing Address - Fax:937-496-5468
Practice Address - Street 1:5777 FAR HILLS AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-2207
Practice Address - Country:US
Practice Address - Phone:937-433-3241
Practice Address - Fax:937-496-5468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH973111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty