Provider Demographics
NPI:1649475757
Name:BACK-N-LINE FAMILY CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:BACK-N-LINE FAMILY CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:SACHIEL-FLINT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:210-287-0050
Mailing Address - Street 1:PO BOX 39844
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-6844
Mailing Address - Country:US
Mailing Address - Phone:210-287-0050
Mailing Address - Fax:
Practice Address - Street 1:8210 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1920
Practice Address - Country:US
Practice Address - Phone:210-287-0050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC 6763111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX609261Medicare ID - Type Unspecified
TXU75639Medicare UPIN