Provider Demographics
NPI:1598270738
Name:BACK IN ACTION CHIROPRACTIC, PA
Entity Type:Organization
Organization Name:BACK IN ACTION CHIROPRACTIC, PA
Other - Org Name:BEELER CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SOMERVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:320-587-6666
Mailing Address - Street 1:903 HIGHWAY 15 S
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-3117
Mailing Address - Country:US
Mailing Address - Phone:320-587-6666
Mailing Address - Fax:320-587-8244
Practice Address - Street 1:903 HIGHWAY 15 S
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350
Practice Address - Country:US
Practice Address - Phone:320-587-6666
Practice Address - Fax:320-587-8244
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BACK IN ACTION CHIROPRACTIC, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-11
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty