Provider Demographics
NPI:1881214617
Name:BACK 2 LIFE CHIROPRACTIC
Entity Type:Organization
Organization Name:BACK 2 LIFE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:IVAN
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-495-6100
Mailing Address - Street 1:8409 SPRUCE ST SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498-2343
Mailing Address - Country:US
Mailing Address - Phone:253-495-6100
Mailing Address - Fax:
Practice Address - Street 1:8409 SPRUCE ST SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98498-2343
Practice Address - Country:US
Practice Address - Phone:253-495-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty