Provider Demographics
NPI:1609222702
Name:BACK TO HEALTH
Entity Type:Organization
Organization Name:BACK TO HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HSU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-631-1906
Mailing Address - Street 1:PO BOX 1905
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98009-1905
Mailing Address - Country:US
Mailing Address - Phone:425-285-9304
Mailing Address - Fax:
Practice Address - Street 1:451 SW 10TH ST
Practice Address - Street 2:STE P
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2981
Practice Address - Country:US
Practice Address - Phone:425-285-9304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-06
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60642775111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty