Provider Demographics
NPI:1992034177
Name:BACK DOCTOR, LLC
Entity Type:Organization
Organization Name:BACK DOCTOR, LLC
Other - Org Name:THE BACK DOCTORS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:RAMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:775-825-0608
Mailing Address - Street 1:550 W PLUMB LN
Mailing Address - Street 2:SUITE A
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3468
Mailing Address - Country:US
Mailing Address - Phone:775-825-0608
Mailing Address - Fax:775-825-0606
Practice Address - Street 1:550 W PLUMB LN
Practice Address - Street 2:SUITE A
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3468
Practice Address - Country:US
Practice Address - Phone:775-825-0608
Practice Address - Fax:775-825-0606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-16
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty