Provider Demographics
NPI:1801089636
Name:BACK TO HEALTH CHIROPRACTIC WELLNESS CENTER, INC.
Entity type:Organization
Organization Name:BACK TO HEALTH CHIROPRACTIC WELLNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:S
Authorized Official - Last Name:CZERMINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:210-599-9570
Mailing Address - Street 1:11465 TOEPPERWEIN RD
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-3138
Mailing Address - Country:US
Mailing Address - Phone:210-599-9570
Mailing Address - Fax:210-599-9572
Practice Address - Street 1:11465 TOEPPERWEIN RD
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3138
Practice Address - Country:US
Practice Address - Phone:210-599-9570
Practice Address - Fax:210-599-9572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6948111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00U49JMedicare PIN
TXU60163Medicare UPIN