Provider Demographics
NPI:1609312172
Name:BACK TO HEALTH WELLNESS CENTER. INC
Entity Type:Organization
Organization Name:BACK TO HEALTH WELLNESS CENTER. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:CHAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHATZLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC, APC
Authorized Official - Phone:505-467-8999
Mailing Address - Street 1:1651 GALISTEO ST STE 12
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-2113
Mailing Address - Country:US
Mailing Address - Phone:505-467-8999
Mailing Address - Fax:505-982-9770
Practice Address - Street 1:1651 GALISTEO ST STE 12
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-2113
Practice Address - Country:US
Practice Address - Phone:505-467-8999
Practice Address - Fax:505-982-9770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-09
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1087111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty