Provider Demographics
NPI:1598474512
Name:BACKWORX CHIROPRACTIC AND DECOMPRESSION, PLLC
Entity Type:Organization
Organization Name:BACKWORX CHIROPRACTIC AND DECOMPRESSION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:ZWIERSTRA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-343-1143
Mailing Address - Street 1:5310 N TARRANT PKWY STE 132
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-7300
Mailing Address - Country:US
Mailing Address - Phone:817-849-2165
Mailing Address - Fax:817-849-2208
Practice Address - Street 1:5310 N TARRANT PKWY STE 132
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-7300
Practice Address - Country:US
Practice Address - Phone:817-849-2165
Practice Address - Fax:817-849-2208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service