Provider Demographics
NPI:1336276492
Name:BACK TO HEALTH CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:BACK TO HEALTH CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:QUADLANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:316-722-1031
Mailing Address - Street 1:7230 W 13TH ST N
Mailing Address - Street 2:STE. 2
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-2982
Mailing Address - Country:US
Mailing Address - Phone:316-722-1031
Mailing Address - Fax:316-722-1014
Practice Address - Street 1:7230 W 13TH ST N
Practice Address - Street 2:STE. 2
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-2982
Practice Address - Country:US
Practice Address - Phone:316-722-1031
Practice Address - Fax:316-722-1014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS660002OtherBCBSKS
KS660002OtherBCBSKS