Provider Demographics
NPI:1780422923
Name:BACK TO BASICS CHIROPRACTIC
Entity type:Organization
Organization Name:BACK TO BASICS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:HOBBY
Authorized Official - Last Name:MERRITT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-370-0260
Mailing Address - Street 1:45 CAREY AVE
Mailing Address - Street 2:SUITE 205 POB 11
Mailing Address - City:BUTLER
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-1475
Mailing Address - Country:US
Mailing Address - Phone:973-370-0260
Mailing Address - Fax:
Practice Address - Street 1:45 CAREY AVE STE 205
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:NJ
Practice Address - Zip Code:07405-1475
Practice Address - Country:US
Practice Address - Phone:973-370-0260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty