Provider Demographics
NPI:1851702211
Name:ROGERS BACK TO HEALTH CHIROPRACTIC
Entity Type:Organization
Organization Name:ROGERS BACK TO HEALTH CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:479-445-3873
Mailing Address - Street 1:2502 W OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-3170
Mailing Address - Country:US
Mailing Address - Phone:479-445-3873
Mailing Address - Fax:479-636-1148
Practice Address - Street 1:2502 W OLIVE ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-3170
Practice Address - Country:US
Practice Address - Phone:479-445-3873
Practice Address - Fax:479-636-1148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR7121225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty