Provider Demographics
NPI:1649500596
Name:BACK2HEALTH - FRENCH LICK, LLC
Entity type:Organization
Organization Name:BACK2HEALTH - FRENCH LICK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SNIDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-882-1241
Mailing Address - Street 1:567 S MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:FRENCH LICK
Mailing Address - State:IN
Mailing Address - Zip Code:47432-2245
Mailing Address - Country:US
Mailing Address - Phone:812-936-6050
Mailing Address - Fax:812-936-6051
Practice Address - Street 1:567 S MAPLE ST
Practice Address - Street 2:
Practice Address - City:FRENCH LICK
Practice Address - State:IN
Practice Address - Zip Code:47432
Practice Address - Country:US
Practice Address - Phone:812-936-6050
Practice Address - Fax:812-936-6051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-28
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty