Provider Demographics
NPI:1659707941
Name:BACK 2 HEALTH - A CHIROPRACTIC & WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:BACK 2 HEALTH - A CHIROPRACTIC & WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEFANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-919-5233
Mailing Address - Street 1:6533 SIMONE SHORES CIR
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-2208
Mailing Address - Country:US
Mailing Address - Phone:813-919-5233
Mailing Address - Fax:
Practice Address - Street 1:110 W SHELL POINT RD
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33570-3705
Practice Address - Country:US
Practice Address - Phone:813-919-5233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10052111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty