Provider Demographics
NPI:1760540561
Name:BACK TO HEALTH CHIROPRACTIC
Entity Type:Organization
Organization Name:BACK TO HEALTH CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR VENTERS OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:VENTERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-499-4432
Mailing Address - Street 1:256 N WITHCDUCK RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:VA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462
Mailing Address - Country:US
Mailing Address - Phone:757-499-4432
Mailing Address - Fax:757-518-8831
Practice Address - Street 1:256 N WITCHDUCK RD
Practice Address - Street 2:SUITE C
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6544
Practice Address - Country:US
Practice Address - Phone:757-499-4432
Practice Address - Fax:757-518-8831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001848302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA115998OtherANTHEM
VA460166OtherASHN
VA460166OtherASHN