Provider Demographics
NPI:1891348421
Name:BACKPEDALERS, PLLC
Entity Type:Organization
Organization Name:BACKPEDALERS, PLLC
Other - Org Name:BRITTIIAN CHIROPRACTIC CENRER, HIGH POINT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GERREN
Authorized Official - Middle Name:Q
Authorized Official - Last Name:BRITTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:678-416-1488
Mailing Address - Street 1:245 EXECUTIVE PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-1503
Mailing Address - Country:US
Mailing Address - Phone:678-416-1488
Mailing Address - Fax:336-232-1580
Practice Address - Street 1:2021 EASTCHESTER DR STE C
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-1566
Practice Address - Country:US
Practice Address - Phone:336-899-7775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-23
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty