Provider Demographics
NPI:1790301471
Name:BACK N' LINE CHIROPRACTIC AND WELLNESS
Entity Type:Organization
Organization Name:BACK N' LINE CHIROPRACTIC AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMI
Authorized Official - Middle Name:G
Authorized Official - Last Name:LAYOUS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-553-9250
Mailing Address - Street 1:482 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-3127
Mailing Address - Country:US
Mailing Address - Phone:503-553-9250
Mailing Address - Fax:
Practice Address - Street 1:482 2ND ST
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97034-3127
Practice Address - Country:US
Practice Address - Phone:503-553-9250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty