Provider Demographics
NPI:1710144852
Name:BACK 2 HEALTH LLC
Entity Type:Organization
Organization Name:BACK 2 HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENS
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANZEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-376-5595
Mailing Address - Street 1:607 B ST JAMES AVENUE
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-2773
Mailing Address - Country:US
Mailing Address - Phone:843-376-5595
Mailing Address - Fax:843-376-5604
Practice Address - Street 1:607 B ST JAMES AVENUE
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-2773
Practice Address - Country:US
Practice Address - Phone:843-376-5595
Practice Address - Fax:843-376-5604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2774111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC6484520001Medicare NSC