Provider Demographics
NPI:1619187234
Name:CHIROPARTNERS
Entity Type:Organization
Organization Name:CHIROPARTNERS
Other - Org Name:BACK ON TRACK CHIROPRACTIC AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:RIZZUTO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:251-955-2225
Mailing Address - Street 1:PO BOX 1446
Mailing Address - Street 2:
Mailing Address - City:ORANGE BEACH
Mailing Address - State:AL
Mailing Address - Zip Code:36561-1446
Mailing Address - Country:US
Mailing Address - Phone:251-955-2225
Mailing Address - Fax:251-980-1945
Practice Address - Street 1:27250 PERDIDO BEACH BLVD
Practice Address - Street 2:STE A
Practice Address - City:ORANGE BEACH
Practice Address - State:AL
Practice Address - Zip Code:36535
Practice Address - Country:US
Practice Address - Phone:251-955-2225
Practice Address - Fax:251-980-1945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1550111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51503323OtherBCBS PREFERRED ID #
AL=========OtherUNITED HEALTH CARE ID #
AL51503323OtherBCBS PREFERRED ID #